Director, Inpatient Coding and Compliance

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Director, Inpatient Coding and Compliance based in the United States.

• Provide administrative leadership for coding services, clinical documentation enhancement, data quality management, and Medical Information Management compliance programs.
• Oversee accurate, timely, and complete coding of inpatient and outpatient accounts using applicable ICD-10-CM/PCS and CPT-4 classification systems and related billing requirements.
• Lead the review and monitoring of coding accuracy, documentation quality, data integrity, billing accuracy, and program timeliness.
• Manage the abstraction of critical data elements required for billing and reporting, including admission type and source, discharge disposition, and attending physician information.
• Develop, maintain, and monitor the department’s compliance plan, including compliance assessments, education, policies and procedures, monitoring activities, and corrective action.
• Ensure coding and data abstraction practices align with applicable CMS regulations and organizational compliance requirements.
• Analyze coding performance and medical record documentation to identify trends, risks, inconsistencies, and opportunities for improvement.
• Partner with data analysts and documentation leadership to monitor Case Mix Index and identify opportunities to improve coding accuracy and documentation quality.
• Respond to identified coding errors and inconsistencies and coordinate appropriate corrective or educational actions.
• Direct continuing education initiatives for coding, documentation enhancement, and data quality management staff.
• Benchmark coding, compliance, quality, and timeliness results against relevant peer organizations and use findings to support continuous improvement.
• Advise administrative, medical, and managerial stakeholders on coding, documentation, compliance, utilization management, financial performance, strategic planning, and information needs.
• Maintain strong working relationships with Case Management, Access and Revenue Management, Business Planning, Information Warehouse, and other organizational partners.
• Provide authorized patient- and physician-specific information from applicable data systems, data marts, and information warehouses for administrative and research purposes.
• Provide departmental leadership, direction, supervision, and support when the Administrative Director is unavailable.
• Resolve intra-departmental and cross-functional issues related to coding, documentation, data quality, and compliance.

• Bachelor’s degree in Health Information Administration or an equivalent field.
• Active Registered Health Information Administrator (RHIA) credential through the American Health Information Management Association (AHIMA).
• At least 10 years of relevant professional experience; 15 or more years is preferred.
• Extensive knowledge of healthcare coding, medical information management, clinical documentation enhancement, data quality, and compliance practices.
• Strong understanding of inpatient and outpatient coding processes, including ICD-10-CM/PCS and CPT-4 classification systems.
• Knowledge of CMS coding, billing, data abstraction, and compliance requirements.
• Demonstrated experience leading teams, programs, policies, and operational initiatives within a complex healthcare environment.
• Strong analytical skills, with the ability to interpret coding, documentation, quality, reimbursement, and performance data and translate findings into actionable recommendations.
• Excellent organizational and problem-solving abilities, with the capacity to manage competing priorities and complex operational issues.
• Strong written and verbal communication skills, including the ability to advise clinical, administrative, financial, and managerial stakeholders.
• Ability to develop and deliver education and continuing professional development programs.
• Strong collaboration skills and the ability to build effective relationships across multidisciplinary departments.
• High level of attention to accuracy, confidentiality, compliance, and data integrity.
• Ability to work independently and provide effective leadership in a fully remote environment.
• Successful completion of a background check is required for final candidates; a drug screen or physical may also be required as part of the post-offer process.

• Fully remote position within the United States.
• Full-time, regular position with a 40-hour workweek and first-shift schedule.
• Medical, dental, and vision coverage, with a significant portion of premiums covered by the employer.
• Paid time off, including vacation and sick leave.
• 11 paid holidays.
• State retirement plan or an alternative retirement plan, with generous employer contributions.
• Opportunity to lead high-impact coding, documentation, data quality, and compliance programs within a large and co