Program Management Lead – Offshore Coding Operations

Program ManagerProgram ManagerFull TimeRemoteTeam 1,001-5,000H1B No SponsorCompany Site LinkedIn

Location

United States

Posted

37 days ago

Salary

$104K - $143K / year

Bachelor Degree5 yrs expEnglish

Job Description

• conducts quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies • optimizes the effectiveness of the offshore coding (post-visit) team • analyzes the performance of the offshore coding team and creates strategies to maximize associate output • cultivates relationships with onshore and offshore coding teams including leaders • serves as liaison and primary point of contact with the offshore (vendor) leaders • advises coding leaders to develop functional strategies (often segment specific) on matters of significance • develops strategies for continuous improvement of offshore coding processes and quality in partnership with Coding Operational Excellence and Regional Coding Leaders • partners with analytics to develop quality assurance program on post-visit reviews • analyzes trends and shares results with coding leaders/teams • monitors quality and addresses performance gaps • researches and interprets correct coding guidelines and internal business rules to respond to inquiries and issues • may participate in coder education programs on coding compliance • follows state and federal regulations as well as internal policies and guidelines while analyzing coding information and medical records • partners with coding teams (consultative coders) on the special handling of Mergers & Acquisitions • leads Special Projects for onshore and offshore coding teams • participates in chart reviews to identify educational opportunities • conducts research as needed • participates in Payer calls/chart reviews • may participate in provider education programs on coding compliance • exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision

Job Requirements

Bachelor’s degree in a relevant field (e.g., Health Information Management, Business Administration, Healthcare Administration)
Active professional certification required: CCS, CRC, or CPC
Minimum 5 years’ progressive experience in medical coding operations
Minimum of 3 years’ direct experience managing or optimizing offshore coding teams and vendor partnerships
Demonstrated success leading cross-functional initiatives and continuous improvement efforts in large, matrixed healthcare organizations
Experience collaborating with analytics, training, and operational excellence teams to drive quality and efficiency in coding workflows
Prior exposure to supporting mergers & acquisitions in a coding operations context preferred
Advanced understanding of medical coding guidelines, healthcare regulations (including HIPAA, state and federal compliance), and payer requirements
Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint) and relevant coding/audit software
Strong business acumen with proven strategic and critical thinking skills
Ability to analyze complex quantitative and qualitative data, synthesize findings, and communicate actionable insights to leadership
Outstanding verbal and written communication skills, with the ability to present to and influence diverse stakeholder groups
Effective relationship-building skills with both onshore and offshore teams, including vendor management and leadership liaison
Proven ability to work successfully in a fast-paced, dynamic, and matrixed environment
Commitment to continuous improvement, operational excellence, and collaborative problem-solving
Public speaking and group presentation experience required
Demonstrated ability to educate and mentor staff on coding compliance and best practices

Benefits

medical, dental and vision benefits
401(k) retirement savings plan
time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
short-term and long-term disability
life insurance
many other opportunities