Assistant General Manager - Coding Operations/Learning & Development/Quality - US Healthcare Process - BPO Services

I. Position Purpose:

The Assistant General Manager - Coding Operations, L&D and Quality assists Vice President - Operations to plan, develop, implement and oversee BPO services initiatives and projects as related to Medical Coding, Learning and Development and Data Quality. They oversee a company's Healthcare coding, auditing and education operations, budgeting responsibilities, involved in hiring and evaluating company personnel and ensuring that interdepartmental workflows are documented and well executed.

II. Position Summary:

The Assistant General Manager - Coding Operations, L&D and Quality is responsible to run the day-to day Healthcare coding and auditing operations, to improve the organizational efficiency by implementing various strategic plans & best practices to provide best services to the clients / customers. This position closely works with VP Operations, and coordination with clients/customers.

III. Essential Job Requirements:

1. Education Bachelor's degree in health information management, Healthcare Administration, life science or related field.

2. Experience - 15+ years of experience into US Healthcare, with at least 5 years of Sr. Managerial experience handling large operations.

- Strong understanding of ICD-10, HCPCS (Levels 1-3), and other relevant coding systems.

- Familiarity with electronic health records (EHR) and coding software.

- Excellent leadership, communication, and problem-solving skills.

- Attention to detail and a commitment to maintaining coding accuracy and compliance.

3. Credentials/Certifications Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) with active certification.

Green Belt or Black Belt preferred with experience in managing operations.

4. Required Skills - 10+ years medical coding experience in multispecialty Inpatient and Outpatient of Facility and Professional components

- 5+ years' experience in managing medical coding Quality and L&D teams

- Must have relevant working experience with US Healthcare, managing multiple clients in both Inpatient and Outpatient.

- Strong organizational, analytical, and problem-solving abilities and techniques with excellent communication and interpersonal skills.

- Ability to lead large teams, schedules, workflow and production.

- Demonstrated excellence in operations and project management role.

5. Preferred Skills Strong Proficiency in MS Office. (Word, Excel, PowerPoint)

6. Productivity Standards Experience in handling 200+ team size mandatory

IV. Position Responsibilities:

1. Set performance goals, conduct regular performance evaluations, and foster a positive work environment.

2. Ensure that medical coding is accurate, consistent, and follows established coding guidelines (such as ICD-10 and HCPCS).

3. Monitor coding processes to ensure compliance with federal and state regulations, as well as insurance and billing requirements.

4. Develop and implement efficient coding workflows to maximize productivity and maintain coding accuracy.

5. Collaborate with other departments, such as Health Information Management and Revenue Cycle, to optimize coding-related processes.

6. Plan resource usage and availability according to client volumes and staff capability, availability and cost.

7. Monitor and Manage Coding staff utilization, overtime and downtime, to ensure efficiency.

8. Plan and offer operational suggestions for the coding and healthcare industries.

9. Introduce the operationally necessary indicators and tools for a smooth and healthy level of productivity in coding and billing.

10. Implement and oversee quality assurance programs to regularly assess coding accuracy and identify opportunities for improvement.

11. Provide feedback and corrective action plans to coders to enhance their skills and maintain high quality standards.

12. Lead the Medical Coding Quality process for internal and Client Billable projects and oversee the quality team's roadmap.

13. Implement quality methods as per industry standard.

14. Stay updated with advancements in medical coding software and tools, recommend the adoption of technologies that improve coding efficiency and accuracy.

15. Organize training sessions and workshops to ensure coders are up to date with coding guidelines and best practices.

16. Support coders in pursuing continuing education opportunities to enhance their coding skills.

17. Oversee entire Medical Coding L&D Team and Plan Industry standard training programs and suggest certification plans.

18. Collaborate with internal IT team related to relevant subject matter content for proprietary software.

19. Generate regular reports on coding productivity, accuracy, and compliance for management review.

20. Analyze coding trends and identify areas for improvement in the coding process.

21. Maintain effective communication with healthcare providers, clinicians, and billing teams to clarify coding-related matters and resolve issues.

22. Attend internal and external meetings within and/or outside of regular business hours.

23. Other responsibilities as required.