Director, Coding Quality Assurance – Education
Employment Information
Report this job
Job expired or something wrong with this job?
Job Description
WVU Medicine director leading enterprise coding quality assurance, audits, education, and compliance across hospital and professional billing. Governing coding technology, vendors, remediation, and executive reporting.
Responsibilities:
- Establish and direct enterprise strategy, governance framework, and operating model for coding quality assurance, audit, education, and validation across Hospital Billing and Professional Billing
- Provide executive oversight of routine, focused, compliance-directed, and risk-based coding audit programs
- Approve and maintain audit methodologies, sampling standards, scoring protocols, quality thresholds, escalation criteria, and remediation expectations
- Analyze coding quality trends, risk indicators, and performance results and advise senior leadership
- Ensure corrective action, remediation, re-audit, and sustained-improvement processes for significant findings
- Lead assigned managers, Coding Auditor/Educator staff, and other quality resources
- Develop and direct enterprise coding education, guidance, onboarding, continuing education, and competency strategies
- Establish career development pathways and support professional development and succession planning
- Direct external coding audits, independent reviews, specialty reviews, and coding quality assessments
- Establish quality requirements and performance measures for external coding partners and vendors
- Partner with Compliance and Coding leadership on reviews, regulatory changes, investigations, risk assessments, and corrective action plans
- Oversee quality monitoring and validation for computer-assisted, AI-assisted, autonomous, and other emerging coding technologies
- Partner with Epic/Information Technology, Compliance, Coding, clinical and operational stakeholders, and technology vendors
- Establish coding quality dashboards, KPIs, executive reporting, and benchmarking methodologies
- Develop annual and long-range priorities, resource plans, staffing models, vendor utilization, budget considerations, technology needs, and strategic initiatives
Requirements:
- Bachelor's degree in Health Information Management, Health Information Administration, Healthcare Administration, Business Administration, or related field and five (5) years of progressive experience in medical coding, coding auditing, coding quality assurance, coding education, compliance, or a related revenue cycle function; OR Associate’s Degree in Health Information Technology and seven (7) years of such experience; OR high school diploma and ten (10) years of such experience plus active coding certification from AHIMA or AAPC
- Three (3) years of leadership experience with responsibility for coding quality, auditing, education, compliance, or a related revenue cycle function
- Expert knowledge of ICD-10-CM, ICD-10-PCS, CPT, HCPCS, official coding guidelines, reimbursement methodologies, payer requirements, and applicable regulatory standards
- Advanced knowledge of coding quality assurance, audit methodology, healthcare reimbursement, compliance principles, documentation requirements, and revenue integrity practices
- Demonstrated ability to lead enterprise programs, establish governance, translate strategic priorities into operational plans, and drive measurable performance improvement
- Strong analytical and critical-thinking skills for interpreting coding quality data, identifying trends and risks, and developing recommendations
- Leadership ability including team development, coaching, performance management, succession planning, change leadership, and management through other leaders
- Excellent written, verbal, presentation, and executive communication skills
- Ability to build partnerships across Coding, Compliance, Revenue Cycle, Information Technology, Finance, clinical, operational, and vendor teams
- Ability to evaluate coding technology, automation, vendor performance, and emerging industry practices
- Prolonged sitting and computer work; frequent use of hands and fingers to operate computers and office equipment; ability to communicate through verbal, written, virtual, and electronic means
Benefits:
- Standard office or remote work environment
- Occasional travel to WVU Medicine facilities or other locations for meetings, leadership activities, training, audits, or operational needs
- Reasonable accommodations may be made for individuals with disabilities
- 40 scheduled weekly hours
- Exempt position
Similar Jobs
Quality Assurance Specialist – Temp Contract
Quality Assurance Specialist reviewing background checks for AccuSourceHR. Ensuring accurate, compliant reports and improving fulfillment processes remotely.
Fresh Food QA Manager
Fresh Food QA Manager overseeing audits, product quality, regulatory compliance, and food safety training across 7-Eleven’s assigned regions.
QA Specialist
Remote QA Specialist reviewing B2B marketing creative across digital, print, and multi-channel campaigns. Ensuring brand consistency, accuracy, compliance, and production excellence for Gravity Global clients.
Manager, Test Development
Manager leading mathematics content and test development for Cambium Assessment’s statewide online assessment programs. Overseeing developers, client meetings, technical reviews, training, and proposal work.
Senior Supplier Quality Engineer
Senior Supplier Quality Engineer leading risk mitigation and quality improvement for aerospace composite suppliers. Supporting L3Harris missile production through supplier assessments, controls, investigations, and corrective actions.
Salesforce QA
Salesforce QA leading testing strategy, automation, and compliance for Yudrio’s federal Salesforce solutions. Managing QA teams and coordinating validation with government stakeholders.
Salesforce QA Consultant
Salesforce QA Consultant testing Salesforce solutions across manual and automated QA. Improving release quality, integrations, regression coverage, and UAT for business stakeholders.
Quality Assurance Engineering
Remote QA Developer building automation frameworks and CI/CD quality practices for Intelex, a provider of EHSQ software solutions. Mentoring QA teams and improving product reliability.
Product Tester – eBooks, Books
Testing Aquana Publishing paperbacks and eBooks from purchase through delivery. Evaluating content and sharing reader feedback with the publishing house.
Middle Manual QA Engineer
Manual QA Engineer testing InvestEngine’s ETF investing platform across web, APIs, SQL, and mobile. Owning quality throughout the customer journey within a fast-moving Growth team.
Principal Quality Engineer – Technical Integrations Lead
Principal Quality Engineer leading automated testing and technical integrations for Nuuvia’s digital youth banking platform. Validating core banking, API, payment, and client-specific workflows.
FIPS 140-3 Security Tester
FIPS 140-3 Security Tester leading entropy-source validation and cryptographic evaluations for DEKRA, a global testing, inspection, and certification provider.
Senior Quality Engineer
Senior Quality Engineer ensuring reliability of a music streaming company’s B2B platform. Leading manual, exploratory, risk-based, and targeted automated testing across web, mobile, and media systems.
Quality Engineer
Quality Engineer managing GxP quality events, investigations, and CAPA processes. Improving Suvoda’s clinical technology quality management system through audits, KPIs, and documentation.
Quality Assurance Specialist
Quality Assurance Specialist supporting Abbott’s medical-device warehousing, inventory, and distribution compliance across EMEA. Managing QMS, CAPA, supplier, distributor, and audit activities.
Senior Manual QA Engineer
Senior Manual QA Engineer testing Seeking Alpha’s web and mobile investment applications. Executing manual, cross-platform, UI, and regression tests while maintaining QA documentation.
Data QA Engineer
Data QA Engineer validating web-extracted customer data for Zyte’s global data extraction platform. Designing tests, analyzing quality metrics, and reporting defects across scraping and AI-assisted projects.
Quality Assurance – Junior
Analista de QA Júnior garantindo qualidade de aplicações em projetos administrativos. Criando testes, acompanhando bugs e promovendo métricas e práticas de qualidade.
Software Tester
Software Tester designing test cases, load testing products, and improving web application quality. Managing SDLC testing projects and mentoring junior testers and developers.
Software QA Tester
Manual Software QA Tester ensuring quality and operational readiness for Input 1's insurance-industry software. Creating test scenarios, documenting results, and supporting bug resolution remotely.