Description
Experience:
- 10–15 years of experience in US Healthcare Medical Coding, Coding Quality, Auditing, or Payment Integrity.
- Strong experience managing coding quality programs across multiple specialties and/or complex healthcare processes.
- Proven experience in client management, quality governance, process improvement, and operational transformation.
- Experience with coding audits, root-cause analysis, quality analytics, performance benchmarking, and corrective action planning.
- Experience leading large teams and mentoring coding auditors, SMEs, and quality professionals.
- Exposure to Lean/Six Sigma, automation, analytics, and technology-enabled quality improvement initiatives is preferred.
Responsibilities
- Drive coding quality governance and process management to consistently meet or exceed client SLAs, quality targets, and contractual requirements.
- Partner extensively with clients to understand coding requirements, establish quality benchmarks, define performance baselines, and set appropriate quality targets.
- Develop and execute coding quality strategies, audit frameworks, and continuous improvement programs aligned with client and business objectives.
- Lead root-cause analysis of coding errors and drive corrective and preventive actions to improve accuracy and reduce repeat defects.
- Oversee quality dashboards, trend analysis, sampling methodologies, audit outcomes, and performance reporting to identify improvement opportunities.
- Act as the key business interface between client quality/transformation teams and EXL Operations, Quality, Analytics, Technology, and Transformation teams.
- Build solid relationships with key client stakeholders and influence decision-making through data-driven insights and quality improvement recommendations.
- Drive standardization and adoption of coding best practices across processes, specialties, and client engagements.
- Promote a Lean Six Sigma culture and use quality tools and methodologies to improv
📌 Senior Manager (Chennai)
🏢 EXL
📍 Chennai