Associate Director – Medical Coding
Location: Hyderabad, Telangana, India
Experience Required: 12+ Years in Medical Coding | 13+ Years in Leadership**
Job Overview
We are hiring an accomplished Associate Director – Medical Coding to lead large-scale operations, drive coding quality programs, and ensure regulatory compliance across multiple healthcare domains. This role requires strong expertise in Risk Adjustment coding, clinical investigations, provider coding, and healthcare operational leadership. The ideal candidate has extensive experience managing large teams and delivering high-quality results in a dynamic healthcare environment.
This position plays a pivotal role in elevating coding accuracy, optimizing operational efficiency, and supporting strategic initiatives across the organization.
Primary Responsibilities
Quality Oversight & Performance Improvement
Lead quality initiatives and implement strategies to enhance accuracy, efficiency, and compliance.
Review audit findings, trends, and non-compliance issues to drive continuous improvement.
Collaborate with supervisors to develop best practices and optimize communication.
Implement proactive measures to mitigate risks impacting project quality and performance.
Evaluate and address variances in production targets and operational goals.
Medical Coding Quality Program Management
Develop coding quality plans aligned with regulatory and payer requirements.
Analyze coding guidelines, payer policies, and client contracts to support operational decisions.
Establish and monitor SLAs, ensuring accuracy, turnaround time, and audit responsiveness.
Review and optimize workflows for efficiency, compliance, and scalability.
Provide expertise to cross-functional teams including operations, quality, and compliance.
Performance Monitoring & Data Analysis
Track coding accuracy, audit results, and compliance trends using dashboards and scorecards.
Validate coding data for accuracy and completeness.
Identify gaps, recommend corrective actions, and support program expansion.
Integrate performance insights into forecasting and operational planning.
Stakeholder Engagement
Build strong relationships with stakeholders across coding, clinical, revenue cycle, and compliance teams.
Lead performance review meetings, audit debriefs, and quality discussions.
Develop and manage corrective action plans to address discrepancies.
Ensure stakeholders stay updated on coding guidelines and regulatory changes.
Compliance & Policy Leadership
Maintain deep knowledge of ICD-10, Risk Adjustment standards, and regulatory requirements (CMS, OIG).
Support the development and revision of coding policies and documentation standards.
Track training completion and compliance metrics across teams.
Ensure adherence to coding policies, documentation requirements, and audit procedures.
Operational Excellence & Financial Performance
Drive continuous improvement in coding accuracy, productivity, and operational quality.
Conduct system and workflow testing to ensure compliance.
Support budgeting and forecasting related to coding resources and audit planning.
Manage resource allocation and assign coding quality projects based on team expertise.
Required Qualifications & Experience
13+ years of leadership experience managing large, cross-functional teams within healthcare operations.
12+ years of specialized experience in medical coding, with emphasis on Risk Adjustment standards and compliance.
Proven experience overseeing clinical case reviews, audit management, and coding accuracy programs.
Hands-on expertise in:
Risk Adjustment Coding
Clinical Investigations
RX Revenue Cycle Management (RCM)
Provider Coding
Demonstrated responsibility for P&L management, driving operational and financial performance.
Experience leading and scaling teams of 350+ FTEs with strong focus on quality and continuous improvement.
Strong project management capabilities in planning, execution, and delivery of quality and compliance initiatives.
About Optum
Optum is a global healthcare organization dedicated to improving health outcomes through technology-driven care. With a commitment to inclusion, innovation, and operational excellence, Optum supports millions of individuals worldwide. Our teams work collaboratively to advance healthcare optimization and deliver measurable value.
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