Operations Manager-Medical Coding

Annova Solutions Pvt Ltd; Indore District; On-site; INR 3,000,000 - 5,000,000; Full time

Job summary

Annova Solutions Pvt Ltd in Indore, India seeks a senior Head of Medical Coding to lead a team of coding professionals and set strategy for accuracy and productivity.

You will ensure ICD-10-CM, CPT, and HCPCS compliance, partner with revenue cycle, CDI, and compliance teams, and drive continuous process improvement. A decade of leadership in healthcare coding is preferred.

Qualifications

• Bachelor's degree in Health Information Management or related field is required.
• CCS certification is required; CPC/CRC/CCS-P are a plus.
• 10+ years in leadership within healthcare, with 7+ years in medical coding.

Responsibilities

• Lead and mentor a team of medical coding professionals.
• Oversee coding operations ensuring compliance with ICD-10-CM, CPT, and HCPCS.
• Drive process improvements and automation initiatives in coding workflows.
• Collaborate with revenue cycle, CDI, and compliance across departments.
• Monitor productivity and quality metrics; conduct audits and deliver coaching.

Skills

Leadership

Mentorship

Team management

Cross-functional collaboration

Process improvement

Regulatory awareness

Stakeholder alignment

Communication

Education

Bachelor's degree in Health Information Management or related field

Master's degree preferred

CCS certification

Tools

EPIC

Cerner

3M Codefinder

Job description

1. Leadership and Team Management:

• Provide leadership, guidance, and mentorship to a team of medical coding professionals.
• Foster a culture of excellence, collaboration, and continuous learning within the coding team.
• Set clear goals and performance expectations for team members and provide ongoing feedback and coaching to support their professional growth and development.

2. Coding Operations Oversight:

• Oversee all aspects of medical coding operations, ensuring adherence to industry standards, regulatory requirements, and organizational policies.
• Monitor coding productivity and accuracy metrics, identifying opportunities for improvement and implementing strategies to enhance performance. o Conduct regular audits and reviews to assess coding quality and compliance, implementing corrective actions as needed.

3. Process Optimization and Innovation:

• Collaborate with cross-functional teams to streamline coding processes, improve efficiency, and drive automation initiatives.
• Stay abreast of industry trends, emerging technologies, and regulatory changes impacting medical coding practices, and proactively incorporate best practices and innovations into coding operations.

4. Compliance and Regulatory Compliance:

• Ensure coding practices align with relevant regulatory requirements, including ICD-10-CM, CPT, and HCPCS coding guidelines.
• Develop and implement policies and procedures to promote coding compliance and mitigate compliance risks.
• Serve as a subject matter expert on coding-related compliance matters, providing guidance and support to internal stakeholders.

5. Stakeholder Collaboration:

• Collaborate closely with other departments, including revenue cycle management, clinical documentation improvement, and compliance, to optimize coding processes and promote cross-functional alignment.
• Partner with healthcare providers, payers, and external vendors to address coding-related issues, facilitate communication, and drive resolution of coding-related challenges.

Qualifications:

• Bachelor\'s degree in Health Information Management, Healthcare Administration, or related field required; Master\'s degree preferred.
• Certified Coding Specialist (CCS) certification required; additional coding certifications (e.g., CPC, CRC, CCS-P) preferred.
• A minimum of 10 years of leadership experience within a healthcare environment, including at least 7 years of medical coding experience with progressively increasing leadership responsibilities.
• In-depth knowledge of ICD-10-CM, CPT, HCPCS coding systems, and coding guidelines.
• Strong understanding of healthcare reimbursement methodologies, compliance requirements, and regulatory guidelines.
• Excellent leadership, communication, and interpersonal skills, with the ability to effectively collaborate with diverse stakeholders.
• Proven track record of driving process improvement initiatives and achieving measurable results.
• Proficiency in healthcare information systems and coding software (e.g., EPIC, Cerner, 3M Codefinder) preferred.