Deputy Director - Quality (Medical Coding)

JOB SUMMARY

We are seeking an experienced Medical Coding leader to join our team in Chennai as Deputy Director. This leadership role involves overseeing quality audits, implementing best practices, driving error reduction initiatives, leveraging automation tools, and fostering a culture of excellence and compliance. This position will play a critical role in enhancing the organization's adherence to regulatory requirements, optimizing processes, and mentoring a team to achieve quality benchmarks.

Key Responsibilities:

• Oversee comprehensive quality audits for coding across in-house teams and multiple vendors

• Enforce coding best practices to mitigate risks such as missed diagnoses, over-coding, or under-coding

• Drive external and internal audit programs aimed at improving compliance and accuracy

• Design and elevate quality control frameworks to ensure coding accuracy and operational efficiency

• Lead initiatives to reduce error rates, enhance coding precision, and boost productivity

• Implement cutting-edge, AI-enabled audit solutions such as automated coding reviews and real-time QA tools

• Monitor and report on Accuracy KPIs, including Missed Error Rate, Extra Error Rate, and Inter-Rater Reliability

• Utilize robust data analytics to assess trends in coding accuracy and identify compliance risks

• Develop executive dashboards and reports to provide insights into quality performance metrics

• Partner with Operations and Training teams to address and resolve coding discrepancies while implementing corrective action plans

• Direct, mentor, and inspire a team comprising QA Managers, Auditors, and Trainers across diverse locations

• Develop and execute quality training programs to enhance coder proficiency and consistency

• Cultivate a culture centered on continuous improvement, compliance, and operational excellence

Job requirements:

• Deep understanding of medical coding standards and audit processes

• Experience with automation and AI solutions in coding audits

• Proficiency in developing and managing quality metrics dashboards

• Strategic leadership and ability to influence cross-functional teams

• Strong problem-solving and decision-making capabilities

• Excellent communication and stakeholder management skills

Qualifications:

• Minimum 13 years of experience in Healthcare Revenue Cycle Management (RCM) and Quality Assurance

• At least 5 to 6 years of core multispecialty coding expertise

• Certified Six Sigma Black Belt/Master Black Belt from recognized institutions (e.g., ISI, ASQ, Benchmark, KPMG) with proven project experience

• Expertise in coding audit frameworks, accuracy improvement strategies, and regulatory compliance

• Certified in AAPC or AHIMA (e.g., CPC, CCS, RHIT, RHIA is preferred)

• Proficiency with AI-powered coding audit tools, process digitization, and automation technologies

• Demonstrated leadership skills with a proven track record of stakeholder management and driving change

• Strong analytical skills with experience in Quality Metrics, Root Cause Analysis (RCA), and Lean Six Sigma