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Assistant Vice President - Surgery / EM @ EXL

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 Assistant Vice President - Surgery / EM

Job Description

Overview: Assistant Vice President is responsible Prepare and present reports on coding audit findings, compliance status, and performance metrics to senior management.

Ensuring accurate coding, compliance, and revenue optimization for surgical services within the organization and are responsible for leading a team of coding professionals and collaborating with other departments, such as Health Information Management, Finance, and Compliance, to ensure alignment of coding practices with organizational goals.

Qualifications: Bachelors degree in clinical or healthcare information management or a related field. Relevant certifications (e.g. CCS, CPC, CPMA) are mandatory.

Strong knowledge of healthcare compliance regulations and reimbursement methodologies.

Extensive experience in medical coding, with a focus on surgery coding and strong knowledge of CPT, ICD-10-CM, HCPCS coding systems.

Experience: Minimum of 15 to 19 years of progressive experience in medical coding, coding auditing, and leadership roles, preferably in a healthcare setting and minimum of 5 years experience in surgical coding or auditing.

Working Hours: 40 HOURS PER WEEK, FULL TIME EMPLOYEE

Working model: Hybrid - Should be able to work from OFFICE for the first 6 months

Skills and abilities: Surgery Ortho, IVR, GI and multispecialty.

Demonstrated leadership and management skills, including the ability to lead and motivate a coding audit team.

Should have experience in E&M Outpatient, Inpatient and ED Coding along with minor surgery procedures.

E&M Inpatient coding experience is mandatory.

Strong analytical and problem-solving abilities to interpret coding audit data and make data-driven decisions.

Excellent communication skills to interact with coding staff, healthcare providers, and senior management, and to present audit findings effectively.

Familiarity with health information systems and coding software tools.

ADDITIONAL AND ESSENTIAL RESPONSIBILITIES:

Regulatory Knowledge: Strong knowledge of ICD-10-CM/PCS, CPT, coding systems, as well as a deep understanding of Medicare and Medicaid reimbursement policies.

Provide inputs and solutions to automatically recognize and extract data from medical documents for proper coding and to facilitate auditing.

Stay updated on changes in coding guidelines, regulations, and reimbursement policies, ensuring the organization's adherence to these standards.

Audit Oversight: Plan, coordinate, and oversee Surgical coding audits to evaluate the accuracy and completeness of coding practices, ensuring compliance with regulatory standards

Data Analysis: Analyze coding audit results to identify trends, patterns, and areas for improvement, and make recommendations for corrective actions.

Quality Improvement: Develop strategies to improve coding accuracy, documentation, and compliance within the organization.

Technology Utilization: Stay current with coding software and technology tools to improve efficiency and accuracy in the coding process.

Reporting: Generate reports on coding and billing performance, identifying trends, and presenting recommendations for improvement to senior management.

Prompt response to all the emails and requirements.

Manage the day-to-day operations to meet the monthly client deliverables with agreed SLAs

Monitor & suggest the effective utilization of resources across the project and review action plan developed to improve.

Leading mentoring and monitoring the performance of Senior Manager to ensure efficiency in process operations.

Review the quality metrics and checking the efficacy of quality improvement plans and sharing suggestions

Creating and sustaining a dynamic environment that fosters development opportunities and motivates high performance amongst team members and organizing quality circle activities

Understanding the customer pain points and provide innovative solutions to improve customer service level

Define KRAs and assess the team performance periodically

Identify the hiring requirement basis the volume forecast and coordinate with senior leadership and hiring team.

Review the managers progress on operational metrics and giving the real time feedback to them

Making sure to review the team is meeting the revenue projections on monthly basis

Implementation of automation opportunities identified by team by coordinating with respective stake holders.

Reviewing the daily/monthly operational reports and addressing any issues

Ensuring Skip level meeting with immediate Reportees

Responsible for creating SOW for new RFP and review the SOP on steady state projects

Driving the employee engagement program for team.

Motivating the next level layers for enrolling them in leadership program to improve their leadership skills

Sharing inputs with senior leadership team on cost optimization

Excellent project management skills, multi-tasking, training skills.

Job Classification

Industry: BPM / BPO
Functional Area / Department: Customer Success, Service & Operations
Role Category: Operations
Role: Operations Manager
Employement Type: Full time

Contact Details:

Company: EXL
Location(s): Hyderabad

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Keyskills:   Surgery Team Management Leadership Surgery coder Quality Surgery coding People Management Skills Evaluation management Operations

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