About IKS Health

IKS Health enables the enhanced delivery of exceptional healthcare for today’s practicing clinicians, medical groups and health systems. Supporting healthcare providers through every function of the patient visit, IKS Health is a go-to resource for organizations looking to effectively scale, improve quality and achieve cost savings through integrated technology and forward-thinking solutions. Founded in 2007, we have grown a global workforce of 14,000 employees serving over 150,000 clinicians in many of the largest hospitals, health systems, and specialty groups in the United States.

IKS Health revitalizes the clinician-patient relationship while empowering healthcare organizations to thrive. We take on the chores of healthcare — spanning administrative, clinical, and operational burdens so that clinicians can focus on their core purpose: delivering great care. Combining pragmatic technology and dedicated experts, our solutions enable stronger, financially sustainable enterprises.

By bringing joy and purpose back to medicine, we’re creating transformative value in healthcare and empowering clinicians to build healthier communities.

Vision

Healthier Communities, Happier Clinicians, Thriving Organizations, Successful Healthcare for All.

Mission

Our mission is to enable the efficient delivery of excellent care. We will deliver on this promise in a manner that makes it a joy for all to work with us; becoming the trusted partner that ensures financial success for our clients and healthier populations in our communities.

What We Do

Revenue Optimizations Services: Our purpose built Revenue Optimization Services reduces administrative burden, maximizes revenue and enables growth at scale while using a variable cost model. Delivered using a technology led platform we transform revenue cycle management, prevent denials, facilitate the patient-provider care journey and maximize contract utilization.

Clinical Support Solutions:

Our Clinical Support Solutions help providers deliver better clinical outcomes, more efficient care, reduce clinician burnout and lower medical costs, resulting in improved physician and patient satisfaction as well as increased enterprise value. All of this while restoring the primacy of the physician-patient relationship in the exam room & beyond.

Value Based Care:

As insurance reimbursement models move towards paying for outcomes, managing population health holistically becomes more important for provider enterprises. Our value-based care solutions allow provider enterprises to succeed across the spectrum of risk by building a patient-centric, provider-led delivery model that coordinates care across the continuum and delivers better clinical, operational and financial outcomes.

Digital Health Solutions:

Our Digital Health Solutions are a robust platform that delivers data-driven value and expertise across the care continuum. It enables provider enterprises to leverage the full potential of their technology assets by helping them build, enhance, maintain and support these critical parts of their IT infrastructure. From a Unified Data Platform to Robotic Process Automation and creating bespoke technology solutions, IKS Health’s Digital Health Solutions help solve some of provider enterprises biggest challenges.

Tech Engineering:

Our Tech Engineering is dedicated to crafting cutting-edge software products and shaping digital customer experiences through our next-generation Care Enablement Platform. Our focus spans across various domains within technology, offering a diverse range of opportunities in Technical Program Management, Software & Product Engineering, Enterprise Architecture, Service Engineering, Interoperability, Test &Process; Automation, Data Engineering, Data Science, BI Reporting, and Data Analytics—all hosted on the cloud. Our commitment lies in harnessing the latest advancements in technology to create solutions that transcend traditional boundaries, fostering a dynamic ecosystem where technology intersects seamlessly with healthcare to drive positive change.

Position: Assoc Director/Director - Quality (Medical Coding) Coimbatore

Department:



Medical Coding – Quality & Compliance

Profile Description

This role is responsible for defining and driving the quality strategy across one or more medical coding portfolios while ensuring coding accuracy, regulatory compliance, client satisfaction, and continuous process improvement. The Director – Quality will lead enterprise quality initiatives, strengthen audit governance, partner with Operations and Training teams, and leverage analytics to improve coding quality, reduce denials, and enhance client outcomes. The role is also responsible for ensuring compliance with industry standards, payer guidelines, and organizational quality frameworks.

Key Responsibilities

Process

- Own the Quality Management System (QMS) across assigned coding portfolios and ensure consistent execution of quality processes.
- Establish and maintain coding quality standards aligned with ICD-10-CM, CPT, HCPCS, payer policies, CMS guidelines, NCCI edits, and specialty-specific coding requirements.
- Drive achievement of internal and client-defined quality SLAs across all accounts.
- Develop audit methodologies including concurrent, retrospective, prospective, focused, and validation audits.
- Ensure calibration across Quality, Operations, Training, and Client teams through standardized audit guidelines.
- Lead root cause analysis (RCA) for quality defects and implement effective corrective and preventive actions (CAPA).
- Monitor coding trends, denial trends, payer edits, and regulatory updates to proactively mitigate quality risks.
- Drive continuous process improvement initiatives through Lean, Six Sigma, and automation opportunities.
- Standardize quality scorecards, audit tools, and governance dashboards across portfolios.
- Ensure readiness for client audits, internal audits, compliance reviews, and external accreditation requirements.
- Establish governance around coding policy changes and ensure timely implementation across operations.

People
- Build and lead a high-performing Quality organization across multiple coding specialties.
- Coach and mentor Quality Managers and Leads to improve audit effectiveness and leadership capabilities.
- Develop competency frameworks for auditors and quality professionals.
- Partner with Operations and Learning teams to identify knowledge gaps and implement targeted training interventions.
- Drive certification programs (AAPC/AHIMA), continuing education, and ongoing competency assessments.
- Promote a culture of quality ownership across Operations rather than quality inspection.
- Drive employee engagement, succession planning, talent retention, and career development within the Quality function.
- Conduct regular calibration sessions to ensure inter-auditor reliability and consistency.
- Foster innovation by encouraging adoption of AI-assisted quality monitoring and analytics.

Client
- Serve as the Quality leader during client governance meetings including Weekly Business Reviews (WBRs), Monthly Business Reviews (MBRs), and Quarterly Business Reviews (QBRs).
- Present quality performance, audit findings, denial trends, and improvement initiatives to clients.
- Build trusted client relationships through proactive communication and consultative quality leadership.
- Partner with client coding compliance teams to resolve coding interpretation differences.
- Support client onboarding, transitions, and implementation activities by establishing quality governance.
- Lead provider education initiatives arising from coding audit findings when required.
- Ensure client quality KPIs, contractual obligations, and compliance expectations are consistently achieved.

Financial
- Improve client ROI by reducing coding defects, rework, denials, and revenue leakage.




- Partner with Operations leadership to improve first-pass quality and operational efficiency.
- Support account profitability by minimizing quality-related cost of poor quality (COPQ).
- Measure and report financial impact of quality improvement initiatives.
- Participate in business reviews and support strategic growth opportunities through quality excellence.
- Drive automation initiatives that improve audit efficiency and reduce manual effort.

Governance & Compliance
- Ensure compliance with HIPAA, CMS regulations, payer-specific guidelines, OIG recommendations, and organizational policies.
- Monitor coding compliance risks and implement mitigation strategies.
- Lead internal compliance audits and support external regulatory audits.
- Maintain documentation supporting quality governance and audit readiness.
- Ensure timely dissemination and implementation of coding guideline updates.

Analytics & Continuous Improvement
- Develop executive dashboards highlighting quality trends, DPU, accuracy, denials, auditor agreement, productivity, and compliance metrics.
- Perform advanced trend analysis using audit data to identify systemic process improvements.
- Utilize statistical quality control techniques and predictive analytics to improve coding performance.
- Lead enterprise quality transformation initiatives leveraging AI and automation.
- Benchmark organizational performance against industry standards and best practices.

Qualifications
- Graduate in any discipline is mandatory.
- BPT, MPT, B.Sc Nursing, M.Sc Nursing, B.Pharm, M.Pharm, BOT, or Life Sciences preferred.
- AHIMA or AAPC certification (CPC, CCS, CCS-P, CIC, CRC or equivalent) is mandatory.
- Lean Six Sigma Green Belt or Black Belt preferred.
- MBA or Master's degree in Healthcare Administration or Quality Management will be an added advantage.
- MBBS, BDS, BAMS, BHMS, or other healthcare professional qualifications would be an added advantage.

Role Prerequisites
- 12+ years of experience in Medical Coding with significant leadership experience in Coding Quality and Compliance.
- Minimum 5 years of managing enterprise quality programs across multiple specialties and clients.
- Extensive experience in coding audits, coding compliance, provider education, and denial prevention.
- Strong understanding of US healthcare regulations, payer policies, CMS guidelines, and coding compliance.
- Experience in leading quality transformation initiatives across large teams (300+ FTE preferred).
- Demonstrated experience working with executive leadership and external clients.
- Experience in AI-enabled quality assurance, analytics, or automation initiatives is preferred.

Functional Competencies
- Expert knowledge of ICD-10-CM, CPT, HCPCS, CMS Guidelines, and NCCI edits.
- Expertise across multiple coding specialties.
- Advanced coding audit methodology and compliance knowledge.
- Solid understanding of revenue cycle management and denial prevention.
- Root Cause Analysis (RCA) and Corrective & Preventive Action (CAPA).
- Statistical quality analysis and performance analytics.
- Governance reporting and executive dashboard preparation.
- Lean Six Sigma process improvement methodologies.
- Client relationship and stakeholder management.
- Advanced Microsoft Excel, Power BI, and Microsoft Office/G-Suite proficiency.
- Knowledge of AI-assisted coding validation and quality monitoring tools is preferred.

Behavioral Competencies
- Accountability
- Customer Service Orientation
- Strategic Thinking
- Developing Others
- Coaching and Mentoring
- Collaboration
- Analytical Thinking
- Decision Making
- Continuous Improvement Mindset
- Communication and Executive Presence
- Change Leadership
- Innovation
- Influence without Authority

Key Success Metrics (KPIs)
- Coding Quality Accuracy (%)
- Defect Per Unit (DPU)
- First Pass Yield (FPY)
- Coding-related Denial Rate
- Audit Completion SLA
- Auditor Agreement / Calibration Score
- Corrective Action Closure Rate
- Client CSAT / Quality Satisfaction Score
- Regulatory Compliance Score
- Cost of Poor Quality (COPQ)
- Revenue Leakage Prevented
- Training Effectiveness Score
- Quality Improvement Project Savings
- Employee Engagement & Attrition within Quality Organization

📌 Associate Director/Director - Quality (for Coding) Coimbatore
🏢 IKS Health
📍 Coimbatore