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Program Management Lead – Offshore Coding Operations

Program ManagerProgram ManagerOtherRemoteSeniorTeam 1,001-5,000H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

128 days ago

Salary

$104K - $143K / year

Seniority

Senior

Bachelor Degree5 yrs expEnglish

Job Description

Program Management Lead – Offshore Coding Operations

CenterWell Senior Primary Care

• 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

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