Omega Healthcare - General Manager - Delivery - Medical Coding

Job Title: General Manager Delivery

Service Line: Medical coding

Location : Hyderabad / Chennai (WFO)

Job Summary:

The GM of Medical Coding is responsible for overseeing the medical coding operations, ensuring compliance with industry regulations, maintaining high accuracy and productivity standards, and managing a team of coders. The DGM / GM will play a key role in driving efficiency, quality, and continuous improvement in the medical coding department, while collaborating with other departments to achieve organizational goals.

Key Responsibilities:

Team Leadership & Management:

- Lead and manage the medical coding team, ensuring high performance, engagement, and professional growth.

- Conduct regular training sessions to ensure staff is up to date with the latest coding practices and industry standards.

- Provide coaching and feedback to improve productivity and accuracy.

Operational Oversight:

- Oversee daily medical coding operations and ensure timely and accurate coding of healthcare services.

- Monitor workflow to ensure departmental goals are met, including productivity targets and quality assurance standards.

- Ensure compliance with the Health Insurance Portability and Accountability Act (HIPAA) and other regulatory requirements.

Quality Control & Compliance:

- Review coding work for accuracy, completeness, and adherence to current coding guidelines (ICD-10, CPT, HCPCS).

- Implement corrective actions and develop strategies to improve coding accuracy and minimize denials.

- Conduct audits and internal reviews to identify issues and implement solutions.

Collaboration & Reporting:

- Collaborate with clinical, billing, and other administrative teams to resolve coding-related queries.

- Analyze coding trends and provide reports to senior management for decision-making.

- Coordinate with insurance companies and healthcare providers to resolve coding discrepancies.

Process Improvement:

- Identify opportunities for process improvement within the coding department to enhance efficiency and reduce errors.

- Develop and implement best practices, standard operating procedures (SOPs), and training materials for the coding team.

Technology Integration:

- Stay up-to-date with coding software, electronic health record (EHR) systems, and new industry trends.

- Lead the integration of new tools and technologies to improve coding processes.

Key Requirements:

Education:

- Bachelors degree or a Masters degree in any field.

- Certification in Medical Coding (e.g., CPC, CCS, CCS-P) is required.

Experience:

- At least 15 to 18 years of experience in medical coding, with a minimum of 8 to 10 years in a managerial role

- Experience in managing large coding teams and driving operational efficiency.

- Familiarity with ICD-10, CPT, HCPCS coding systems and compliance regulations.

- Experience in specialities like HCC, E&M, ED, IPDRG etc.

Skills:

- Strong leadership, communication, and interpersonal skills.

- In-depth knowledge of medical coding practices, healthcare reimbursement, and regulatory requirements.

- Ability to manage and analyze large sets of data and make data-driven decisions.

- Proficient in using coding software, EHR systems, and MS Office Suite (Excel, Word, PowerPoint).

Personal Attributes:

- Attention to detail with a focus on accuracy and compliance.

- Ability to work under pressure and manage multiple priorities.

- Strong problem-solving and decision-making skills.