14 Oct
|
Black Turtle
|
Bengaluru
14 Oct
Black Turtle
Bengaluru
Role & responsibilities
- Lead end-to-end HCC medical coding operations, ensuring quality, productivity, accuracy, and turnaround time (TAT) targets.
- Manage large-scale coding teams, including managers, team leaders, auditors, and coders.
- Oversee risk adjustment coding for Medicare Advantage and other applicable US healthcare programs.
- Ensure compliance with CMS guidelines, ICD-10-CM coding standards, and applicable risk adjustment regulations.
- Drive coding accuracy, audit performance, risk adjustment validation, and continuous improvement initiatives.
- Monitor operational KPIs, SLAs, productivity, quality metrics, and financial performance.
- Lead client interactions, business reviews, escalations, and strategic stakeholder engagements.
- Develop operational strategies for capacity planning, resource optimization, training, and performance management.
- Collaborate with quality, training, compliance, and technology teams to improve coding efficiency.
- Drive automation, process standardization, and operational transformation initiatives.
Required Skills & Qualifications
- 15-20+ years of experience in US Healthcare RCM, with significant expertise in HCC / Risk Adjustment coding.
- Proven experience leading large-scale medical coding operations at a senior leadership level.
- Solid knowledge of ICD-10-CM, CMS guidelines, Medicare Advantage, and risk adjustment methodologies.
- Experience managing multiple delivery teams and operational managers.
- Strong understanding of coding quality audits, compliance, productivity, and performance metrics.
- Excellent client management, communication, stakeholder management, and problem-solving skills.
- Experience in process improvement, operational transformation, and technology-enabled coding solutions.
- Relevant coding certifications such as CPC, CRC, CCS, or equivalent are preferred.
Preferred Candidate Profile
- Experience as Senior Manager, Director, or Associate Director in a US Healthcare RCM organization.
- Demonstrated success in managing high-volume HCC coding delivery operations.
- Strong business acumen, people leadership, and client-facing capabilities.
- Ability to drive operational excellence while maintaining coding accuracy and regulatory compliance.
Key Focus Areas: HCC Risk Adjustment | US Healthcare RCM | Medicare Advantage | ICD-10-CM | Large-Scale Team Management | Client Delivery | Quality & Compliance
📌 Associate Director (Bengaluru)
🏢 Black Turtle
📍 Bengaluru