Senior Director of Coding at Healthrise in Location not listed

Apply Description We are seeking an experienced, hands-on leader to join our team in a consultative capacity to support client engagements focused on evaluating and optimizing charging and coding practices across hospital (facility) and professional fee (profee) service lines. This individual will serve as a subject matter expert in clinical coding and/or revenue integrity/charge capture, leading assessments and initiatives that drive compliance, accuracy, and revenue integrity across client engagements. The Senior Director will partner with client stakeholders to analyze current-state workflows, validate coding accuracy across both facility and professional fee settings, and implement actionable recommendations that strengthen mid-cycle performance as well as front and back-end performance. This role is ideal for a hands-on professional who thrives in a fast-paced consulting environment and can translate regulatory requirements into operational improvements. This leader will serve as a key driver of sustainable mid-cycle improvements that enhance accuracy, standardization, and financial integrity across client organizations, and will oversee blended onshore/offshore coding teams delivering that work. DUTIES AND RESPONSIBILITIES Key Responsibilities: Knows, understands, incorporates, and demonstrates the Healthrise Core Values in all interactions with team members, clients, and stakeholders. Perform detailed assessments of charging and coding practices across facility and professional services (i.e., complex service lines such as cardiology and neurosurgery, ASCs and IP/OP facility) to identify compliance risks, revenue leakage, and process inefficiencies. Evaluate Charge Description Master (CDM) structure, charge capture workflows, and coding alignment with DRG, CPT, HCPCS, ICD-10, and payer-specific requirements across both facility and profee coding. Analyze documentation, coding patterns, and charge utilization to identify optimization opportunities and root causes of revenue variance. Validate inpatient (facility) coding accuracy, including MS-DRG and APR-DRG assignment, principal diagnosis selection, POA indicators, and SOI/ROM capture, to ensure compliant case-mix and reimbursement integrity. Validate professional fee (profee) coding accuracy, including E/M leveling, CPT/HCPCS assignment, modifier usage, and specialty-specific coding guidelines. Develop structured findings, gap analyses, and prioritized recommendations aligned to regulatory guidance and industry best practices. Lead project workstreams focused on implementation of charging and coding improvements, including workflow redesign, charge capture controls, and CDM updates. Partner with client operational leaders, revenue integrity teams, compliance, and clinical departments to support adoption of recommended changes. Translate complex regulatory requirements into practical operational guidance. Support development of executive-level summaries outlining financial impact, compliance exposure, and implementation roadmap. Support response to inpatient and professional fee coding-related denials and external audits (RAC, MAC, payer DRG validation), including rebuttal development and root-cause remediation. Collaborate with cross-functional teams to ensure alignment between clinical documentation, coding, and charge capture processes. Partner with Clinical Documentation Integrity (CDI) teams to address documentation gaps affecting facility and professional fee code assignment, query practices, and DRG accuracy. Utilize Epic and/or other EHR reporting tools to validate charge logic, identify trends, and support data-driven recommendations. Lead and manage blended coding teams across onshore and offshore resources, including direct oversight of third-party coding vendors (performance management, quality oversight, and SLA accountability). Maintain project documentation including status updates, issue tracking, and mitigation strategies. Travel to client or organizational sites as required to support on-the-ground project execution. Performs other duties as assigned. QUALIFICATIONS Required: Active coding credential required, such as CCS, CCS-P, CPC, COC, CIC, RHIA, or RHIT (AHIMA or AAPC), or equivalent. Demonstrated hands-on coding experience across both facility (inpatient/outpatient) and professional fee (profee) coding, with specialty expertise in cardiology and/or neurosurgery. Prior experience leading or participating in charging assessments and CDM reviews across facility and professional service lines. Required experience leading and managing blended coding teams across onshore and offshore resources, including direct oversight of third-party coding vendors (performance management, quality oversight, and SLA accountability). Strong project management skills with the ability to manage multiple initiatives simultaneously. Experience presenting to and communicating with executive-level audiences. Proficiency in Epic or comparable EHR systems, including reporting functionality. Ability to interpret data and translate findings into actionable operational recommendations. Strong written and verbal communication skills with ability to present findings to operational and executive stakeholders. Ability to manage multiple workstreams in a project-based environment. Willingness and ability to travel as needed, minimum quarterly travel. Completion of regulatory/mandatory certifications as required. Preferred: Master's degree (MHA, MBA, or equivalent). Certified Professional Coder (CPC), Certified Revenue Cycle Professional (CRCP), HFMA Fellow (FHFMA), or equivalent industry certification. Lean Six Sigma Green Belt or Black Belt; demonstrated experience facilitating rapid improvement events (Kaizen, RCA workshops). Experience with AI/automation tools applied to revenue cycle (RPA, AI-assisted coding, intelligent denial routing). Familiarity with No Surprises Act, price transparency requirements, and other recent regulatory developments affecting hospital and physician billing. PHYSICAL DEMANDS AND WORK ENVIRONMENT Work Environment: Operates in a variety of professional settings — corporate offices, client hospitals and health system campuses, remote home office, and travel environments. Must be comfortable adapting to new physical and technological environments quickly and frequently. Physical Demands: This is largely a sedentary role; however, employees may need to use keyboards, mouse, and other devices for typing, clicking, and navigating software systems. Schedule: Standard business hours with flexibility required during crisis deployments, go-live activations, or client-driven escalations. Occasional evening or weekend availability may be required in high-urgency situations.