Associate Vice President – Coding

Credence Global Solutions; Pune District; On-site; INR 3,500,000 - 6,000,000; Full time

Job summary

Credence Global Solutions is seeking an experienced Operations leader for RCM to oversee end-to-end medical coding and denial management.

The role requires guiding teams, setting up start-up projects, educating providers and clients on compliant coding, and maintaining high client satisfaction.

Ideal candidate has 15+ years of coding experience, ICD-10 and E/M expertise, and leadership at director level.

Qualifications

• Certified coder.
• 15+ years of work experience including coding audits, Pre adjudication, Work flow, Lab panel recommendation.
• Strong expertise on ICD-10, E&M and Pathology & Laboratory coding.
• Ability to supervise quality reviews for delivery teams.
• Current designation should be Director (3.5+ years) or Senior Director (1.5+ years).

Responsibilities

• Manage End to End medical coding and Denial coding teams.
• Guide/Lead team to fix front end Denial/rejection coding.
• Setup start-up projects and pitch in with client Solutions using coding capabilities.
• Educate Providers/clients with correct coding methodology to remain compliant.
• Drive Client Relationship, Service Delivery and Internal Stakeholder Management.
• Create confidence among employees for smooth operations and achievement of targets.
• Provide directions and structure for operating units.
• Identify delivery issues with client physicians and resolve them.
• Implement improved processes for ROI and workflow optimization.
• Create and manage frameworks to deliver high-quality work.
• Work with delivery and training to create feedback loops from quality assessment to operations.
• Maintain knowledge of current coding certifications and review payer policies.

Skills

ICD-10 coding

E/M coding

Pathology & Laboratory coding

Denial coding

Team leadership

Client relationship management

Process improvement

Quality reviews supervision

Training coordination

Workflow optimization

Education

Certified coder

Job description

Operations (RCM)

Job Roles & Responsibilities

• Managing Coding for different specialty through the understanding of medical terminology, AMA guidelines, anatomy, physiology and procedures (Laboratory experience will be an added advantage)

• Heading the End to End medical coding, Denial coding Team.

• Should be able to Guide/Lead team to fix front end Denial/rejection coding

• Setup start-up projects

• Should use coding capability skills to pitch in Clients with solutions
• Educating Providers/clients with correct coding methodology to remain compliant

• Client Relationship , Service Delivery and Internal Stakeholder Management
• Create confidence among the employees for smooth operations and achieving organization targets

• Provide directions and structure for operating units

• Identify delivery issues or areas of concern for the client, work with the team and client physicians to resolve concerns/issues
• Implement improved processes and management methods to generate higher ROI and workflow optimization
• Create and manage operational frameworks to deliver good quality of work

• Work with delivery and training functions to create feedback loops from quality assessment to training and operations management

• Track record of delivering high quality services

• Ensuring attrition control

• Promote teamwork and cooperative effort

• Relationship with key decision makers in target market

• Ensure high client satisfaction level

• Establish the best practice across the coding services

• Attends coding and reimbursement workshops/Webinar as required

• Maintains knowledge of current and required coding certifications
• Reviews payer polices/Documents at a regular interval and update the team

Candidate Requirements

• Certified coder

• 15+ years of work experience, including experience in coding, coding audits, Pre adjudication, Work flow, Lab panel recommendation

• Strong expertise on ICD -10, E&M and Pathology & Laboratory coding

• Ability to provide supervision on quality reviews to the delivery team.
• Current Designation should be Director with 3.5+ years or Senior Director with 1.5+ years of work experience