Quality Company
Healthcare
AGM-HIMServices
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“AGM - HIM Services at Quality Company. Skills: Quality Assurance, Process Transformation, Client Management, Team Development. Manage daily workflows for medical coding quality audit. Maintain transactional accuracy targets”
What You'll Achieve.
Exceed financial health goals; Meet accuracy targets; Exceed accuracy targets; Meet client SLAs; Exceed client SLAs; Reduce turnaround times; Reduce operational costs
Industry & Context.
Root-cause analysis; Denial analyses
Regular eye-hand coordination, Manual dexterity, Function in an environment with constant interruptions, Sitting for prolonged periods, Lift and move material weighing up to 20 lbs, Elevated levels of stress
What They're Looking For.
Must Have
Bachelor's degree in Health Information Management, Bachelor's degree in Life Sciences, Bachelor's degree in Healthcare Administration, Bachelor's degree in a related field, Active CPC certification, Active CCS certification, Active CIC certification, Active COC certification, Minimum 7 years experience in healthcare revenue cycle management, Minimum 4 years in medical coding quality supervisory role, Minimum 4 years in medical coding quality management role, Operational experience with major EHRs, Operational experience with encoder software, Operational experience with automated billing platforms, Operational experience with automated coding platforms, Proven track record managing delivery teams, Ability to perform work at a computer terminal for 6-8 hours a day, Ability to function in an environment with constant interruptions
Nice to Have
CIC certification preferred, COC certification preferred, Lean Six Sigma Green Belt certification highly desirable, Experience with Epic EHR, Experience with Cerner EHR, Experience with 3M encoder software
What You'll Do.
Manage daily workflows for medical coding quality audit
Maintain transactional accuracy targets
Enforce transactional accuracy targets
Establish feedback mechanisms
Communicate audit findings to production managers
Act as project lead for implementing automation tools
Act as hands-on project manager for deploying autonomous
Act as hands-on project manager for deploying CAC
Act as hands-on project manager for deploying workflow
Identify operational bottlenecks
Eliminate operational redundancies
Apply Lean methodologies
Reduce turnaround times
Reduce operational costs
Perform deep-dive denial analyses
Partner with Training & Operations
Deploy targeted remediation plans
Monitor client-specific quality metrics
Analyze client-specific quality metrics
Present client-specific quality metrics
Serve as primary point of contact for routine
Serve as primary point of contact for audit
Recruit Quality Lead Auditors
Recruit Subject Matter Experts
Mentor Quality Lead Auditors
Mentor Subject Matter Experts
Conduct performance appraisals for Quality Lead Auditors
Conduct performance appraisals for Subject Matter Experts
How You'll Work.
Team & Collaboration
Cross-functional teams; Production managers; Training & Operations
Communication Scope
Present client metrics; Audit rebuttals
Process & Methodology
Project management
Full Job Description
**About Us:** Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. **ESSENTIAL DUTIES AND RESPONSIBILITIES: ** **Note:** The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member. This role bridges the gap between executive strategy and front-line execution. This role directly oversees a team of Quality Auditors, ensures strict adherence to international coding standards, and acts as the project lead for implementing automation tools, such as AI-driven Computer-Assisted Coding (CAC). Key Responsibilities 1\. Quality Assurance & Performance Management * **Daily QA Operations:** Manage daily workflows for the medical coding quality audit teams across multiple specialties * **Accuracy Governance:** Maintain and enforce transactional accuracy targets, ensuring the delivery team consistently meets or exceeds the client SLAs * **Feedback Loops:** Establish structured feedback mechanisms to communicate audit findings to production managers, facilitating rapid, data-driven corrective actions. 2\. Process Transformation & Technology Execution * **Automation Deployment:** Act as the hands-on project manager for deploying autonomous coding systems, CAC software, and w
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