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Director, Coding And Compliance | Usa

5-10 years
Not Disclosed
10 Nov. 26, 2025
Job Description
Job Type: Full Time Education: B.Sc./ M.Sc./ M.Pharm/ B.Pharm/ Life Sciences Skills: Causality Assessment, Clinical SAS Programming, Communication Skills, CPC Certified, GCP guidelines, ICD-10 CM Codes, CPT-Codes, HCPCS Codes, ICD-10 CM, CPT, HCPCS Coding, ICH guidelines, ICSR Case Processing, Interpersonal Skill, Labelling Assessment, MedDRA Coding, Medical Billing, Medical Coding, Medical Terminology, Narrative Writing, Research & Development, Technical Skill, Triage of ICSRs, WHO DD Coding

Director, Coding and Compliance | USA

Full-Time | Leadership Role | Healthcare Coding & Compliance

Position Overview

We are seeking an accomplished Director of Coding and Compliance to lead organizational efforts in coding accuracy, regulatory adherence, and clinical documentation integrity. This senior leadership role is responsible for overseeing coding education, compliance audits, provider training, and operational improvement initiatives. The Director will collaborate with physicians, coders, clinical teams, revenue cycle leaders, and executive management to ensure that all coding and billing practices align with federal and state regulations.

This position plays a critical role in strengthening financial sustainability, supporting high-quality patient care, and driving long-term operational excellence.


Key Responsibilities

  • Lead regular audits of coding and billing processes to ensure accuracy, compliance, and documentation integrity.

  • Analyze coding data to identify patterns, trends, compliance risks, and opportunities for improvement.

  • Develop and implement strategies to enhance coding quality and reduce documentation or billing errors.

  • Maintain current knowledge of regulatory updates, coding guidelines, risk management requirements, and industry standards.

  • Design, develop, and deliver coding education programs for coders, billing teams, physicians, and healthcare providers.

  • Provide training on clinical documentation improvement (CDI), coding standards, documentation requirements, and compliance expectations.

  • Serve as the primary liaison between coding teams and providers to resolve coding issues and support accurate documentation.

  • Establish and monitor key performance indicators, operational goals, and productivity benchmarks.

  • Lead initiatives for workforce development, including recruitment, training, performance management, and continuous improvement frameworks.

  • Manage escalated client concerns, ensuring timely issue resolution and proactive communication.

  • Collaborate with cross-functional teams to maintain consistent service delivery and operational alignment.

  • Oversee documentation development, workflow optimization, and process standardization across coding and compliance functions.

  • Ensure adherence to all policies, internal controls, and HIPAA regulations for the protection of patient information.

  • Monitor and report monthly performance metrics, ensuring full compliance with organizational and regulatory requirements.


Qualifications

  • Bachelor’s degree in a related field or equivalent combination of education and experience.

  • 5+ years of experience in Revenue Cycle Management (RCM).

  • 10+ years of leadership and training experience in healthcare coding or related functions.

  • Certified by AAPC or AHIMA in medical coding (required).

  • Experience working with multiple practice management systems.

  • Advanced proficiency in Microsoft Word and Excel.

  • Strong analytical skills with the ability to identify trends and recommend actionable improvements.

  • Excellent written and verbal communication abilities.

  • Demonstrated experience in risk management, health information management (HIMS), and provider collaboration.

  • Proven experience partnering with medical leadership and senior management to execute strategic initiatives.

  • Commitment to continuous operational improvement and high-quality performance standards.


Experience Required

  • Minimum 5 years of hands-on RCM experience.

  • Minimum 10 years of leadership, training, or management experience in coding, compliance, or documentation improvement.

  • Demonstrated expertise in coding guidelines, regulatory requirements, billing compliance, and audit management.


Why This Role Is Critical

The Director of Coding and Compliance ensures that healthcare organizations maintain accurate, compliant, and efficient coding practices. Through leadership, education, and data-driven oversight, this role directly supports operational integrity, financial performance, and high-quality patient care.