Strategy & Operations Consultant – Coding Optimization and Automation

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

📋 Description

• Evaluate and restructure the coding department's organization, roles, and task distribution.

• Discover and apply automation prospects, such as Epic coding functionalities, CAC/autonomous coding, and AI-driven tools.

• Outline the scope of automation, establish workflows, and set success metrics.

• Integrate Epic with operational processes, including the design of workqueues, routing and assignment rules, and claim edits.

• Create or enhance quality assurance programs for facility and professional coding.

• Formulate coder onboarding, continuous education, competency initiatives, and scalable provider training.

• Set coding key performance indicators (KPIs) and reporting for metrics like productivity, accuracy, backlog, DNFB, coding-related denials, and turnaround time.

• Provide guidance to client coding and revenue cycle leaders.

• Manage workstreams, oversee deliverables, and relay progress, risks, and outcomes to executive stakeholders.

• Distribute production coding, denials, and claim edit tasks among staff with coding expertise.

• Deploy Epic coding-related AI tools.

• Enhance Epic hospital simple visit coding.

• Automate level-of-service coding and billing for ambulatory and emergency department settings.

• Develop E/M coding education and quality assurance programs for ambulatory providers at scale.

⛳️ Requirements

• Over 7 years of experience in healthcare coding, health information management, coding operations, revenue integrity, or revenue cycle management.

• Proven experience in leading or significantly influencing a coding department or operations.

• Experience in both hospital and professional coding.

• In-depth knowledge of CPT, ICD-10-CM/PCS, and E/M coding standards.

• Demonstrated success in utilizing technology or automation to enhance coding processes.

• Practical experience in developing or refining coding quality assurance programs, coder and provider training, and productivity benchmarks.

• Track record of measurable outcomes such as productivity enhancements, reductions in backlog or DNFB, improvements in accuracy, or increased automation rates.

• Experience in optimizing coding workflows within Epic, including workqueues, rules, and associated operational workflows.

• Excellent communication, facilitation, and executive presence.

• Capability to lead workstreams and juggle multiple priorities effectively.

• Bachelor's degree is mandatory.

• Willingness to travel up to 80%, based on engagement requirements.

• Familiarity with Solventum (previously 3M) or comparable coding and CDI technology is preferred.

• Coding credential (CCS, CPC, RHIA, RHIT, or equivalent) is preferred.

• Experience in healthcare consulting is preferred.

🏝️ Benefits

• Eligibility for annual performance bonuses.

• Additional benefits and perks may be provided, depending on the role and employment conditions.

• A supportive, enjoyable, honest, and autonomous work atmosphere.

• A diverse and inclusive environment where employees are valued and empowered.