Director - Medical Coding Operations

We are seeking an experienced and knowledgeable Director of Medical Coding with expertise in US Healthcare In patient & Out Patient coding. The ideal candidate will have a deep understanding of medical coding systems, including ICD-10, CPT, and HCPCS, as well as coding guidelines and regulations. The Director will be responsible for leading a team of medical coders, ensuring accurate and compliant coding practices, and driving continuous improvement initiatives. Proficiency in CPC, COC, CIC, CCS certifications is essential for success in this role.

Responsibilities:

Lead and manage a team of medical coders responsible for accurately assigning diagnostic and procedural codes to medical records.

Develop and implement coding policies, procedures, and best practices to ensure compliance with coding guidelines, regulations, and payer requirements.

Stay updated with industry changes and regulatory updates related to medical coding, reimbursement methodologies, and documentation requirements.

Provide guidance and training to coding team members on coding principles, guidelines, and updates to ensure consistent and accurate coding practices.

Conduct regular audits and quality assessments to evaluate coding accuracy, compliance, and identify areas for improvement.

Collaborate with cross-functional teams, including physicians, clinical documentation improvement specialists, and revenue cycle management, to address coding-related issues and implement process improvements.

Monitor coding productivity, turnaround times, and accuracy metrics to ensure departmental goals and targets are met.

Stay informed about emerging trends and technologies in medical coding, such as computer-assisted coding (CAC) systems, and evaluate their potential impact on coding operations.

Oversee the coding team's performance, including workload distribution, productivity, and professional development.

Foster a culture of continuous learning, collaboration, and innovation within the coding team.

Qualifications:

MBBS / BHMS / BAMS/ BDS with Masters or a related field.

Minimum of 18 years of experience in medical coding within the US healthcare industry, with a focus on inpatient, outpatient, or professional coding.

Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Inpatient Coder (CIC), or Certified Coding Specialist (CCS) certification is required.

In-depth knowledge of medical coding systems, including ICD-10, CPT, and HCPCS, as well as coding guidelines (e.g., Official Guidelines for Coding and Reporting) and compliance regulations (e.g., HIPAA).

Experience managing and leading coding teams, including assigning work, monitoring performance, and providing feedback and coaching.

Strong understanding of reimbursement methodologies (e.g., Medicare, Medicaid, commercial insurance) and their impact on coding practices.

Familiarity with coding-related software and technology, including electronic health record (EHR) systems, encoder software, and computer-assisted coding (CAC) tools.

Excellent analytical and problem-solving skills, with the ability to interpret complex medical documentation and apply appropriate coding principles.

Effective communication and interpersonal skills, with the ability to collaborate with physicians, administrators, and stakeholders at all levels of the organization.

Detail-oriented and organized, with the ability to prioritize tasks, meet deadlines, and manage multiple projects simultaneously.

Knowledge of healthcare compliance regulations, privacy laws (e.g., HIPAA), and industry standards (e.g., CMS guidelines).