AVP / Senior Director - Coding Quality Job in
- Consultancy
- 15 to 20 Yrs
- Chennai
- 1 month ago
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Job Description
- Access Healthcare is seeking a highly experienced Quality Assurance leader for the position of Assistant Vice President / Senior Director - Medical Coding. This role will be responsible for managing end-to-end quality audits for coding across multiple vendors and internal teams. The ideal candidate will have strong leadership and stakeholder management skills, with the ability to drive change and lead quality improvement initiatives. Eligibility Criteria: Overall, 18-20 years of overall experience in a BPO/KPO/Health care services with minimum 15 years experience in Service Quality (Quality Assurance/Transactional quality). Six sigma Black Belt/Master Black Belt certified from reputed institutions like ISI, ASQ, Benchmark, KPMG etc., along with project experience. Minimum 5-6 years for Core Coding experience is required. Certified in AAPC or AHIMA certifications (CRC, CPC, CCS, RHIT, or RHIA preferred). Competency Requirement (Technical & Behavioral): Quality Assurance & Compliance Oversee end-to-end quality audits for coding across multiple vendors and in-house teams. Ensure 100% compliance with CMS Risk Adjustment guidelines, ICD-10 coding standards, and HIPAA regulations. Implement and enforce coding best practices to minimize missed diagnoses, over-coding, and under-coding. Lead external and internal audit programs to improve accuracy and compliance. Process Optimization & Error Reduction Establish and enhance quality control frameworks to improve coding accuracy and efficiency. Drive initiatives to reduce error rates, improve coding precision, and enhance productivity. Implement AI-driven audit solutions (e.g., automated coding reviews, real-time QA tools) to optimize efficiency. Monitor Accuracy KPIs (Missed Error Rate, Extra Error Rate, Inter-Rater Reliability). Data-Driven Insights & Performance Improvement Utilize data analytics to identify trends in coding accuracy, compliance risks, and vendor performance. Develop dashboards and reporting mechanisms for leadership visibility on quality performance metrics. Collaborate with Operations & Training teams to address coding discrepancies and drive corrective action plans. Team Leadership & Training Lead and mentor a team of QA Managers, Auditors, and Trainers across multiple locations. Develop quality training programs for coders to enhance their proficiency and ensure coding consistency. Foster a culture of continuous improvement, compliance, and performance excellence. Key Qualifications & Skills: Deep knowledge of ICD-10-CM, Model, Medicare Advantage, and Risk Adjustment Guidelines. Strong experience in audit frameworks, accuracy improvement, and compliance enforcement. Expertise in AI-powered coding audit tools, automation, and process digitization is a plus. Strong leadership and stakeholder management experience, with the ability to influence change and drive quality initiatives. Data-driven mindset with experience in Quality Metrics, Root Cause Analysis (RCA), and Lean Six Sigma methodologies.,
Employement Category:
Employement Type: Full timeIndustry: Medical / Healthcare
Role Category: Not Specified
Functional Area: Not Specified
Role/Responsibilies: AVP / Senior Director - Coding Quality Job in
Contact Details:
Company: Access HealthcareLocation(s): Chennai
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Keyskills: Medicare Advantage Automation
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