job description
Join R1 RCM, a global leader in revenue cycle management, as an Operations Manager – Medical Coding and take the helm of our quality assurance initiatives in the dynamic healthcare sector. This remote role, based in Bali, offers you the unique opportunity to blend professional excellence with a tropical work-life balance.
As the Quality Manager, you will spearhead coding QA processes, ensuring unparalleled accuracy, compliance with industry standards (e.g., ICD-10, CPT, HCPCS), and continuous operational improvement. Your leadership will drive efficiency, reduce errors, and enhance revenue integrity for our clients. This is a chance to make a tangible impact in healthcare administration while growing your career in a supportive, innovative environment.
Ideal for seasoned professionals with a passion for precision and process optimization, this role combines strategic oversight with hands-on collaboration. Whether you’re refining workflows, mentoring coding teams, or analyzing performance metrics, your work will directly contribute to the financial health of healthcare providers worldwide.
Responsibility
- Lead and oversee medical coding quality assurance (QA) processes to ensure 98%+ accuracy in code assignments.
- Develop and implement compliance frameworks aligned with ICD-10, CPT, HCPCS, and payer-specific guidelines.
- Monitor and analyze coding productivity and accuracy metrics, identifying trends and areas for improvement.
- Collaborate with cross-functional teams to streamline workflows and reduce claim denials or rejections.
- Conduct regular audits of coded data, providing feedback and training to coding staff.
- Drive continuous improvement initiatives, including process automation and tool enhancements.
- Serve as the primary liaison for client escalations related to coding discrepancies or compliance concerns.
- Stay abreast of industry updates (e.g., CMS, AMA) and integrate changes into operational protocols.
Qualifications
- Bachelor’s degree in Healthcare Administration, Nursing, or a related field (or equivalent experience).
- Minimum 5+ years of experience in medical coding, with 2+ years in a leadership or QA role.
- Certification as a CPC (Certified Professional Coder), CCS (Certified Coding Specialist), or equivalent is required.
- Deep expertise in ICD-10-CM, CPT, and HCPCS coding systems and revenue cycle management.
- Proven ability to analyze data and generate actionable insights using tools like Excel or SQL.
- Strong communication and stakeholder management skills, with experience working in a global or remote team.
- Familiarity with EHR/EMR systems (e.g., Epic, Cerner) and coding software (e.g., 3M, Optum).
- Commitment to compliance and ethical standards in healthcare documentation.