Senior Director, Coding and Documentation

This is a fully remote position, open to applicants in Florida, +11 more states.

📋 Description

• Report directly to the CFAO, providing strategic oversight for the coding, documentation, and audit/education departments.

• Support the operations of the owned clinic and affiliated businesses.

• Lead and manage the coding and documentation teams.

• Collaborate with senior leadership to ensure alignment of functions with compliance, clinical requirements, and company policies.

• Offer guidance on coding guidelines, educational programs, and Medicare Advantage processes.

• Drive strategic initiatives utilizing analytical tools.

• Monitor the quality and productivity of coder work.

• Ensure timely and effective completion of physician and coder documentation audits.

• Provide corrective actions and educational support as necessary.

• Collaborate with clinical and operations leadership on annual education, disease prevalence, and preventative screening initiatives.

• Support a compliant Medicare Advantage risk adjustment strategy using CMS and HCC models.

• Manage risk adjustment business processes and act as a subject matter expert on related regulations.

• Assist with department budgeting, forecasting, goals, and initiatives.

• Maintain KPIs and reporting for both internal and external stakeholders.

• Enhance CMS revenue accuracy and completeness through prospective assessments and retrospective chart reviews.

• Partner with contracted health plans regarding documentation and audit requests.

• Collaborate with Revenue Cycle Management and outsourced vendors to resolve coding issues.

• Oversee the internally developed pre-review coding workflow tool and support EMR vendor coding workflow matters.

• Supervise department managers and team leads for Pre-Review Coding, Coding Education, Coding Audit, and MSO Coding.

⛳️ Requirements

• 10+ years of experience in Medicare Advantage coding and documentation.

• 7+ years of leadership experience.

• Experience in primary care settings.

• CPC, CRC, and/or CPMA certifications are required.

• A bachelor's degree is mandatory.

• Leadership abilities to effectively guide work and support other departmental professionals.

• Capable of professional communication with all levels of leadership.

• Exceptional written and oral communication skills.

• Proficient technical writing skills for documentation development, implementation, maintenance, and presentations to leadership.

• Ability to communicate and uphold the integrity of sensitive, detailed information.

• Understanding of Microsoft Office, medical terminology, medical procedures, and services.

• Ability to assess work and patient needs concerning departmental practices, procedures, and computer systems.

• Strong knowledge of the medical field and its practices.

• Skill in operating technology and various IT systems.

• Must be willing to work extended and flexible hours, including weekends as necessary.

• Must be capable of performing essential functions such as typing, standing, sitting, stooping, and occasionally climbing.

• Must be able to travel/drive to medical centers in all company regions and expanding markets.

🏝️ Benefits

• Equal opportunity/affirmative action employer.

• Reasonable accommodations may be provided to enable individuals with disabilities to perform essential functions.