Vice President - CSS Coding - Medical Coder (15-25 yrs)

Vice President : CSS - Coding

Department - Clinical Support Solutions - Coding

Location - Mumbai / Hyderabad

- As an integrated Provider Enablement Platform is a go-to resource for providers and organizations looking to effectively scale, improve quality and achieve cost savings through integrated technology and forward thinking solutions.

- The care delivery process and business solutions are driven through four interrelated Feature Clusters or Product Suite

- Revenue Optimization Services: We offer a comprehensive financial solution that maximizes revenue, maximizes cash, and minimizes the cost of collections for our customers. This line of business boasts of solutions like Revenue

- Cycle Management (RCM), Denial Prediction Engine, POS Collection, Liability Estimation, AR Decision Support Tools, Real-time Adjudication, & more.

- Clinical Support Solutions: Suite of clinical support services that help providers deliver better clinical outcomes, better patient satisfaction, and lower medical costs, resulting in improved clinician engagement Synchronous & Asynchronous Scribe. AssuRx, Migrate, Stacks, Inbox Management, Pre-Visit Summary, Coding Solutions, and Synchronous Clinical Concierge.

- Value Based Care: We support our customers through an array of solutions that help them achieve better outcomes and therefore greater value for the care provided. Some of these solutions include Risk & Quality Optimization, Care Coordination, TCM, CCM, Patient Navigators, Utilization Management (UM), Medicine Reconciliation and Adherence, and Payment Reconciliation and Adjudication.

- Digital Health Solutions: A platform that delivers data-driven value and expertise across the care continuum. It enables provider enterprises leverage the full potential of their technology assets by helping them build, enhance, maintain, support, and manage their IT assets, including building unifying data platforms; creating bespoke IT solutions leveraging Hyper Automation, Data/Analytics, Interoperability Solutions, Application Engineering; & so on.

- Health provides an excellent platform for leaders with exceptional clinical talent as well as experience in leading and managing a business unit. currently impacts over 35000+ physicians with leading health systems in the US.

- With a strongly visible pipeline, solutions will start touching and improving the lives of many more physicians in the next couple of years.

Profile Description:

The AVP of Coding will be responsible for ensuring that the Sites operations of Coding meet or exceed client requirements and are operationally efficient. It is critical that we quickly ramp to scale and establish industry wide best practices across the coding services. This role will lead the site for the coding Line of Business.

Key Responsibilities:

Process:

- Accountable for delivery of operations as per SLAs for all accounts aligned to them.

- Responsible for managing end to end transitions and migrations of new accounts

- Collaborate with the Client and the Client services team towards efficient execution of Operations and the business.

- Ensure governance and smooth functioning of Operations as well as with clients, through daily calls and meets, Weekly/ Monthly/Quarterly reviews

- Bring about Process Improvement to overcome identified gaps in the process.

- Manage the Budgeted Headcount to the optimum capacity.

- Responsible for final invoices and accuracy of invoices of his/her account(s)

- WFM: Maintain Detailed Capacity Plan at account level

- Data Analysis: Prepare Collective Dashboard and conduct cross Functional analysis of Quality data,

RVU, and Coding for Client Calls.

- Collaborate with sales in building the business and to design new offerings.

- Ensure focus and execution of the key measurements for the role and i.e. Revenue, Gross Margin, and Customer Satisfaction

- Contribute to the development of short and long term strategies operational goals.

- Should be able to guide operations on functional aspects of coding and endeavor to improve coding standards in the team.

- Ensure best in class Operations: Create and manage operational frameworks to deliver high quality work in the field of medical coding.

- Liaison with internal stakeholders

- Work with delivery leaders to launch and lead six sigma quality projects across Coding

- Responsible for new developments (in discussion with Practice team) across coding

- Accountable for managing headcount optimization across all accounts in consultation with the PL/AVPs and ensure resources are utilized

People:

- Provide functional support and direction to the team.

- Boost the morale of the employees and develop a work environment based on equity and meritocracy

- Maintain fairness in the performance management system and create an environment of guidance, mentoring and development of teams.

- Review whether the training needs of all operation employees identified and training is imparted to develop the level of employees as expected

- Accountable for the performance management and improvement of the Bottom Quartile employees

- Accountable for overall people engagement in coding

- Responsible for assessing hiring requirements across levels in discussion with WFM.

- Responsible for hiring decisions based on headcount/P&L and planning of supervisor/leadership for the FY based on budgets.

- Work on attrition mitigation plan for the vertical

- Define career paths and development goals for every individual in the team.

- Ensuring a Learning culture through constant training needs identification, training program coverage at all levels as per development plans for his/her account/department designed in the Career Architecture.

- Ensuring that all programs planned for Self Development are completed.

Client:

- Accountable for preparing dashboards/reports for the client and senior management

- Work with client services and ML's to create new solutions for existing or new accounts

- Responsible for partnering in the implementation/transition of new accounts.

- Ensure all new accounts are implemented based on agreed timelines in discussion with the client(s)

- Manage high Customer Satisfaction Levels.

Financial:

- Accountable for overall P&L for the vertical, revenue forecasts, budgeting, and liaising with market

leaders on new/existing SOWs, implementation of COLA, minimum billing clauses.

Functional Competencies:

- Strong expertise on ICD -10 and CPT with any of the specialties would be preferred.

- Deep understanding of the coding guidelines with the ability to provide supervision on quality reviews to the delivery team.

- Detailed understanding of the end to end RCM cycle related to US healthcare and related key areas of measuring success would be preferred.

- Ability to Lead, guide and mentor large delivery teams.

- Familiarity with clinical documentation coding

- Should be flexible in travelling within India as well as to the US.

- Client Management Skills

- Good Governance and Process Improvement ability

- Good knowledge and experience of handling P&Ls and Budgets at an account level

Education & Experience

- Should be a graduate from any field.

- AHIMA/AAPC certification is a must.

- BPT, MPT, BSC Nursing, MSC Nursing, B Pharm, M Pharm, BOT, Life Science would be preferred.

- MBBS, BDS, BAMS, BHMS, BUMS etc would be an added advantage.

- 12+ years experience in running core coding operations including having significant experience in

coding audits, workflow assessments, onsite and remote client management is a must.

- Experience of managing and working on P&L of the business OR account is a must.