Senior Post-Acute Coding & Compliance Lead

Omega Healthcare Management Services Pvt. Ltd.; Town of Florida, Northern (NY, KY); Hybrid; USD 120,000 - 180,000; Full time

Benefits offered by this job

Health, Dental, Vision

401(k) with employer match

Professional development opportunities

Paid time off

Holiday pay

Job summary

Omega Healthcare Management Services seeks a senior Coding Quality Leader to define and maintain master manuals for PDPM/PDGM and LTC. You will design standardized workflows and create templates for enterprise-wide use, ensuring consistent delivery across teams.

You will lead the audit framework, RCA efforts, and curriculum development for post-acute hires, acting as SME for complex coding issues and owning coding software. Strong CMS knowledge and leadership are essential.

Qualifications

• 10-12 years of progressive experience in medical coding, auditing, and compliance across SNF, Home Health and LTC environments.
• Proven success in client-facing roles such as pre-sales support, solution architecture, or functional delivery leadership in a BPO/outsourcing context.
• Deep knowledge of ICD-10-CM, CPT/HCPCS, MDS/RAI, PDPM, OASIS-E, PDGM, and audit frameworks (RAC, MAC, ADR).
• Strong understanding of CMS regulations, payer policies, HIPAA compliance.
• Credentials: AHIMA CCS/RHIA/RHIT or AAPC CPC.
• Preferred: CDIP, CCDS, CRC, COQS or equivalent; RN/PT/OT/SLP licensure a plus.

Responsibilities

• Define and maintain coding manuals for SNF, PDPM, PDGM, and LTC.
• Design standardized workflows for delivery teams to ensure consistency.
• Create templates, forms, and checklists for enterprise use.
• Design the audit framework (scorecard) for coding accuracy.
• Lead RCA when accuracy drops below 95% and develop corrective actions.
• Develop curriculum and certification for post-acute hires.
• Conduct Train-the-Trainer sessions on CMS regulations and payer policies.
• Serve as SME for complex coding gray areas and MQ rulings.
• Act as Functional Owner for coding software (Epic, CAC, AI tools).
• Collaborate with IT to optimize EHR templates and automated triggers.

Skills

Client Relationship

Communication

Electronic Health Records

HIPAA Training

ICD10 Coding

Inpatient Rehabilitation

Interpersonal Skills

Long-Term Care

Medical Terminology

Microsoft Office

Nursing Care

Occupational Therapy

Physical Therapy

Project Management

Skilled Nursing Facilities

Speech Language Pathology Assessments

Education

AHIMA CCS/RHIA/RHIT or AAPC CPC

CDIP, CCDS, CRC, COQS credentials

Nursing/Clinical background preferred

Tools

Epic

CAC

AI tools

Job description

Omega Healthcare Management Services seeks a senior Coding Quality Leader to define and maintain master manuals for PDPM/PDGM and LTC. You will design standardized workflows and create templates for enterprise-wide use, ensuring consistent delivery across teams.

You will lead the audit framework, RCA efforts, and curriculum development for post-acute hires, acting as SME for complex coding issues and owning coding software. Strong CMS knowledge and leadership are essential.