Skill Requirement:

- Bachelors or master's degree - Life sciences/Medicine.

- Coding certification from AAPC - CCS; CCS-P; CPC etc.

- Minimum 8-10 years of medical coding and QA experience in professional coding and/or facility coding and Denial management.

- Experience of working across multiple coding specialties, denial management and operations.

- Strong knowledge of coding domains - E/M, ED, Radiology, Surgery, Pathology, IP DRG, HCC & Denial Management.

- Strong knowledge of coding/Denial Management operations, People & Process management.

- Should have handled a Team of 45+ coders.

- Excellent relationship building and mentoring skills.

- Excellent communication and presentation skills across all levels.

- HIPAA compliant and compliant with all Industry policies and procedures.

Roles & Responsibilities:

- Review and monitor day-to-day Medical coding/denial management operations and Service Level Agreements.

- Take ownership of organization's coding team certification goals by preparing and mentoring the coders for different certification programs.

- Be a subject matter expert to guide team for accurate coding.

Think Strategic

(a) Big Picture Perspective:

- Understands the process vision & has the ability to translate the same to the team

- Demonstrates an understanding of the impact of team's performance on sub /process objectives

- Reviews own actions against the process objectives

- Identifies long term issues, problems or opportunities for the team

(b) Business Acumen:

- Appreciates the inter-dependencies between teams/functions

- Understands impact of business metrics on profitability

- Suggests solutions based on inferences from the data

- Demonstrates expertise in functional knowledge

- Demonstrates functional expertise to coach/mentor peers/team members

Drive Results

(a) Planning & Organizing:

- Cost optimization and maximum utilization of resources for productivity

- Comes out with new ideas for process improvements to enhance customer service.

- Responsible for preparation of process budget and manpower.

(b) Directing & Monitoring:

- Manages day-to-day operations of the Unit, including attendance, attrition and outages, to minimize customer impact.

(c) Accountability:

- Manages Average Handling Time (AHT) as per SLAs

- Accountable for the production and quality targets of the Unit

- Managing the profitability of the process

(d) Problem Solving & Decision making

- Is able to identify problems and take decisions independently

- Provides solutions to individual and organizational problems

Partner with Customers

a) Relationship Building

- Coordinating with the client on process related issues and updates

b) Passion for excellence

- Manages daily performance to ensure that all Associates and Team Leads are meeting SLAs.

- Meets/exceeds service and quality levels as assigned by Management/Client.

- Uphold Our Client/Company values

Lead People

a) Managing Self

- Identify and participate in training / developmental programs

b) Inspiring others / managing teams

- Coaches and mentors Associates & Team Leads

- Optimum utilization of resource to meet productivity.

- Interview candidates to ensure quality of Hire.

- Conducting performance appraisals

- Identify key people and mentor leaders

- Conducting team reviews, submitting progress reports of the team to the Program Lead

Interested Candidate can send your updated resume 

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