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Job Description
- You are a highly experienced Quality Assurance leader sought by Access Healthcare for the role of Assistant Vice President / Senior Director - Medical Coding. In this position, you will oversee end-to-end quality audits for coding across various vendors and internal teams. Your key responsibilities include ensuring compliance with CMS Risk Adjustment guidelines, ICD-10 coding standards, and HIPAA regulations. You will also be expected to implement coding best practices to minimize errors and lead audit programs to enhance accuracy and compliance.
To be eligible for this role, you should possess 18-20 years of overall experience in BPO/KPO/healthcare services, with at least 15 years in Service Quality. Additionally, you must have a Six Sigma Black Belt/Master Black Belt certification from reputable institutions and a minimum of 5-6 years of Core Coding experience. Being certified in AAPC or AHIMA certifications is also preferred.
Your competency requirements should include expertise in Quality Assurance & Compliance, Process Optimization & Error Reduction, Data-Driven Insights & Performance Improvement, as well as Team Leadership & Training. You should have a deep understanding of ICD-10-CM, Model, Medicare Advantage, and Risk Adjustment Guidelines. Your skills should encompass audit frameworks, accuracy improvement, compliance enforcement, and AI-powered coding audit tools.
As a leader, you will be responsible for mentoring a team of QA Managers, Auditors, and Trainers across multiple locations. Developing quality training programs for coders and fostering a culture of continuous improvement will be key aspects of your role. Your data-driven mindset and experience in Quality Metrics, Root Cause Analysis (RCA), and Lean Six Sigma methodologies will be instrumental in driving quality initiatives and influencing positive change within the organization.,
Skills
Quality AssuranceAIpowered Coding Audit ToolsProcess Optimization Error ReductionTeam Leadership TrainingDataDriven Insights Performance ImprovementLean Six Sigma MethodologiesMedicare AdvantageQuality Assurance ComplianceAutomationRisk Adjustment GuidelinesICD10CMIf a job posting appears fraudulent, asks for payment, contains misleading information, or violates our guidelines, please report it immediately. Our team will review it promptly, Jobaaj does not charge any fee from the applicants.
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