[Hiring] Director, Coding Quality Assurance @US Acute Care Solutions

Role Description

The Director, Coding Quality Assurance – Inpatient and Emergency Medicine, provides leadership to the Coding Quality Assurance Inpatient and Emergency teams by establishing tools, workflows, SOPs, policies, and procedures to ensure consistency across all coding organizations. The Director monitors coding quality results to ensure the quality and production of work by USACS coders, and vendor partner coders maintain Coding Quality Assurance Programs (CQAP) across multiple specialties. This role is also accountable for developing and maintaining a process to identify risk and partners with clinicians, coding education, and operations to ensure quality scores exceed industry expectations.

Essential Job Functions:

• Visioning, Strategic Leadership, & Planning – 50%
  • Develop and execute the strategic direction for the Coding Quality Assurance Inpatient and Emergency teams.
  • Establish and maintain QA frameworks, policies, workflows, and SOPs to ensure consistency in coding practices.
  • Monitor coding accuracy trends and performance metrics to identify risks and improvement opportunities.
  • Partner with coding operations, coding education, and clinical leadership to ensure coding quality performance meets organizational and industry benchmarks.
  • Collaborate with coding vendor partners to promote consistency in processes.
  • Develop quality performance goals, benchmarks, and tools to support quality improvement.
  • Identify emerging trends impacting coding quality and implement proactive strategies.
• Quality and Operational Oversight – 25%
  • Oversee the Coding QA program, including auditing processes.
  • Monitor QA scores for internal and external coders by specialty. Provide feedback to education and operation teams to establish action plans.
  • Ensure the integrity and reliability of coding quality metrics and reporting.
  • Identify and recommend initiatives and programs for coding quality improvements.
  • Identify any potential coding quality risk and initiate remediation plan which may require continuous monitoring and evaluation.
  • Collaborate with coding operations and education teams to address discrepancies and identify gaps.
  • Evaluate trends to identify training opportunities and operational improvements.
• Shaping Team Culture & Development – 15%
  • Provide leadership and direction to the Coding Quality Assurance team.
  • Recruit, develop, and mentor QA staff promoting a culture of accountability and continuous improvement.
  • Conduct regular performance discussions, coaching, and development planning.
  • Sets a positive example in collaborating initiatives, identifying solutions, measuring, and sharing results, and providing feedback.
• Professional Development – 10%
  • Maintain expertise in coding standards, regulatory requirements, and industry best practices.
  • Participate in continuing education, professional development, and industry forums.
  • Serve as a mentor and resource for staff and emerging coding professionals.

Qualifications

• Strong knowledge of medical coding principles, regulatory requirements, and compliance standards.
• Demonstrated leadership experience managing coding quality assurance programs.
• Ability to analyze coding quality data and translate findings into actionable improvement initiatives.
• Strong collaboration and stakeholder management skills across multi-disciplinary teams.
• Excellent communication and presentation skills.
• Proven ability to lead continuous improvement initiatives and manage performance metrics.
• Strong analytical, problem-solving, and organizational skills.
• Proficiency in Microsoft Office applications, with emphasis on Excel.
• Ability to identify, research and solve problems and discrepancies.
• Ability to maintain confidentiality and handle sensitive information.

Requirements

• Associate degree required; Bachelor’s or Master’s degree preferred.
• RHIT, RHIA, CCS-P, CPC or other job-related certification required.
• 6+ years’ coding experience and leadership/supervision experience required.
• 6+ years of relevant experience managing coding inventory across a large physician practice or multi-site healthcare organization with high accountability for quality and production metrics.
• 6+ years of relevant experience managing HIM/Coding workflow and data capture processes, including within an electronic medical records system.
• 6+ years of relevant experience in managing multiple, large coding teams and/or projects, and influencing senior-level management and key stakeholders.

Physical Demands

• While performing the duties of this job, the employee is regularly required to sit for prolonged periods and occasionally walk, stand, bend, stoop, and lift up to 15 pounds.
• Required to have close visual acuity to perform the job.

Benefits

• Medical, dental, and vision insurance options
• Health savings accounts (HSA) and flexible spending accounts (FSA)
• 401(k) employee and employer contributions
• Paid time off, including vacation, sick leave, and company holidays
• Paid parental leave & family support benefits
• Short-term and long-term disability insurance
• Life and accidental death & dismemberment (AD&D) insurance
• Employee assistance programs & wellness resources
• Additional compensation may include bonus eligibility, equity, or other incentive programs, depending on the role.