Director – Coding, Audit, Compliance, Operational Excellence

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

📋 Description

• Provide strategic leadership for coding, audit, compliance, and revenue cycle initiatives.

• Act as a trusted advisor to clients, offering clear and actionable recommendations.

• Ensure the delivery of precise, high-quality, and audit-defensible work products.

• Lead executive-level presentations and client discussions.

• Guide and advise on Revenue Cycle Management (RCM) projects, including coding, billing, audit, and revenue integrity.

• Oversee RADV/HCC audits and strategies for documentation improvement.

• Assess provider documentation and coding accuracy to ensure compliance with CMS and payer standards.

• Identify opportunities to enhance reimbursement, risk capture, and operational effectiveness.

• Mentor and develop Managers, Auditors, and consulting personnel.

• Provide direction on engagement execution, quality benchmarks, and client communication.

• Cultivate a collaborative, high-performing team atmosphere.

• Build and maintain client relationships to foster growth.

• Identify and seek out new business prospects.

• Engage in proposals, presentations, and industry events.

• Contribute to thought leadership efforts, including publications and speaking opportunities.

⛳️ Requirements

• 8+ years of experience in the healthcare sector.

• Proven track record in Revenue Cycle Management (RCM) and healthcare operations.

• Demonstrated proficiency in HCC/risk adjustment coding and documentation.

• Strong understanding of ICD-10-CM, CPT®, and HCPCS coding.

• Knowledge of E/M documentation guidelines.

• Familiarity with CMS regulations and payer requirements.

• Experience with revenue cycle processes (coding, billing, denials, reconciliation).

• CPC, CPMA, and CRC certifications required.

• Bachelor’s degree preferred.

🏝️ Benefits

• Opportunities for professional development.