Director, Coding and Compliance – USA
Location: United States
Category: Coding Compliance | Revenue Cycle | Healthcare Operations
Experience Required: 5+ years in Revenue Cycle Management and 10+ years in leadership/training
Position Overview
The Director of Coding and Compliance is a senior leadership role responsible for ensuring the accuracy, integrity, and regulatory compliance of medical coding and clinical documentation practices across healthcare organizations in the United States. This position oversees coding compliance programs, leads education and training initiatives, and ensures all coding-related activities align with federal and state regulations.
The Director will work closely with physicians, coders, clinical teams, and operational leadership to improve documentation quality, enhance revenue cycle performance, and support organizational financial sustainability. This role is critical to maintaining high standards of coding accuracy, operational efficiency, and regulatory compliance.
Key Qualifications
Bachelor’s degree in a relevant field or equivalent combination of education, training, and experience.
5+ years of experience in Revenue Cycle Management.
10+ years of leadership and training experience in healthcare coding or compliance functions.
Valid coding certification from AAPC or AHIMA (mandatory).
Hands-on experience with multiple practice management and coding systems.
Strong analytical skills with the ability to interpret data, identify trends, and recommend operational improvements.
Expert-level proficiency in Microsoft Word and Excel.
Proven experience collaborating with medical staff leadership and senior management.
Knowledge of risk management, Health Information Management Systems (HIMS), and compliance frameworks.
Exceptional written and verbal communication skills.
Demonstrated commitment to continuous improvement, quality, and regulatory alignment.
Core Responsibilities
Conduct comprehensive audits of coding and billing practices to ensure compliance with regulatory requirements and identify opportunities for improvement.
Analyze coding and billing data to detect trends, compliance risks, and process gaps, while developing strategies to enhance coding accuracy and reduce errors.
Monitor updates to coding regulations, payer policies, and documentation requirements to ensure organizational adherence.
Design, implement, and oversee coding education programs for coders, providers, and billing staff.
Provide training on documentation standards, CDI best practices, coding guidelines, and compliance protocols.
Serve as a liaison between coding teams and healthcare providers to support communication and resolve complex coding-related issues.
Establish key performance indicators (KPIs), monitor operational results, and implement corrective actions to address performance gaps.
Lead recruitment, training, development, and performance management initiatives for the coding and compliance teams.
Manage high-priority client expectations and proactively address issues impacting service quality and operational success.
Resolve escalated issues promptly and effectively through cross-functional collaboration.
Develop and document standardized processes, workflows, and operational guidelines.
Oversee monthly performance reporting, ensuring full adherence to policies, regulatory standards, and HIPAA guidelines.
Maintain responsibility for internal controls aligned with organizational objectives.
Ensure proper handling of Protected Health Information (PHI) in compliance with HIPAA regulations.
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Japan | Saitama |Tokyo :
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