Associate Director – Billing, Coding

This is a fully remote position, open to applicants in Connecticut.

📋 Description

• Supervise professional coding operations directly.

• Ensure compliance with payer and regulatory guidelines for accurate CPT, HCPCS, and ICD-10 coding.

• Track coding productivity and quality on a daily and weekly basis.

• Perform routine internal audits and promptly address any coding discrepancies.

• Lead corrective action initiatives when audit outcomes do not meet target thresholds.

• Stay updated with CMS, payer, and specialty-specific coding changes.

• Oversee the accurate and timely entry of charges for all clinical services.

• Monitor the lag time from service date to claim submission.

• Identify and rectify any missing charges, interface issues, and documentation deficiencies.

• Implement measures to minimize unbilled inventory and prevent revenue loss.

• Validate modifiers and ensure compliance with payer-specific billing regulations.

• Review daily work queues and charge edit reports.

• Step in directly for complex or high-risk coding situations.

• Engage in root cause analysis for denials related to coding or charge capture.

• Collaborate with AR leadership to tackle issues of downcoding, bundling, and medical necessity denials.

• Monitor and strive to decrease coding-related denial rates.

• Conduct thorough vendor performance evaluations, including QC outcomes and productivity assessments.

• Escalate issues and require documented remediation strategies.

• Actively participate in operational calls to discuss aging, denials, and backlog.

• Assess cost efficiency and suggest insourcing when beneficial.

• Directly manage coding supervisors, leads, and charge entry personnel.

• Establish clear expectations for productivity and accuracy.

• Conduct performance evaluations and coaching sessions.

• Provide continuous education and specialized training.

• Cultivate high-performing coders with expertise in complex surgical and procedural coding (if applicable).

• Collaborate with physicians and practice leadership to enhance documentation quality.

• Work closely with Revenue Cycle leadership to boost clean claim rates.

• Partner with IT on system edits, charge interfaces, and automation initiatives.

• Support new service lines and acquisitions by managing coding setup and validating charge masters.

• Track and report on essential performance indicators: Coding accuracy rate, Productivity benchmarks, Charge lag days, Coding-related denial rate, Unbilled inventory.

• Provide monthly reporting and operational improvement recommendations to RCM leadership.

⛳️ Requirements

• Bachelor’s degree or equivalent work experience.

• CPC, CCS-P, or a comparable professional coding certification is mandatory.

• 5–8+ years of progressive coding experience, including leadership roles.

• Background in orthopedic, multi-specialty physician practices, or large healthcare organizations.

• Strong understanding of payer reimbursement methodologies.

• Experience in managing high-volume professional coding environments.

• Proficiency in EHR and practice management software.

• Strong technical knowledge in coding.

• Operational discipline and effective workflow management skills.

• Attention to detail.

• Knowledge of regulatory compliance.

• Capability in team leadership and accountability.

• Data-driven approach to decision making.

• Skills in problem-solving and managing escalations.

🏝️ Benefits

• Excellent growth and advancement opportunities.

• Dynamic work environment.

• Access to a diverse network of practitioners.

• Comprehensive infrastructure of tools and programs to enhance the employee experience.

• Competitive compensation.

• Generous paid time off.

• Comprehensive benefits package including health, dental, vision, 401(k), etc.