Director, Coding

Overview The Director of Coding leads enterprise coding operations across HB and PB services, including PBB coding, quality assurance (QA), and training/education. This leader is accountable for accurate, timely ICD-10-CM/PCS, CPT, and HCPCS code assignment and abstracting, strong coding quality governance, audit readiness, and pre-bill edit/hold performance that reduces discharged not final coded (DNFC) and discharged not final billed (DNFB), improves claim quality, and minimizes coding-related denials and compliance risk. The Director partners with Clinical Documentation Integrity (CDI), Health Information Management (HIM), Billing/Patient Financial Services, Revenue Integrity, clinical leaders, and IT to standardize workflows, optimize encoder/computer-assisted coding (CAC) capabilities, and drive performance transparency. Qualifications Education: Bachelor’s degree in Health Information Management, Healthcare Administration, Business Administration, Nursing, or a related field required. Master’s degree preferred. Experience: Minimum of 7 years of progressively responsible experience in healthcare coding, Health Information Management (HIM), revenue cycle, or a related field. Minimum of 5 years of leadership experience required. Experience overseeing Hospital Billing (HB) and Professional Billing (PB) coding operations in an academic medical center, health system, or large integrated delivery network strongly preferred. Experience with:Provider-based billingEpicCoding quality programsDenial managementAudit response processesRegulatory compliance initiatives License/Certification/Registration: One of the following nationally recognized coding certifications is required and must be maintained in good standing:RHIA (Registered Health Information Administrator)RHIT (Registered Health Information Technician)CCS (Certified Coding Specialist)CCS-P (Certified Coding Specialist - Physician-based)CPC (Certified Professional Coder)COC (Certified Outpatient Coder)CIC (Certified Inpatient Coder)CPMA (Certified Professional Medical Auditor)Equivalent nationally recognized coding certification Additional leadership, auditing, compliance, or revenue cycle certifications preferred. Demonstrated expertise in:Team leadership and talent developmentStaff coaching and succession planningPerformance management and accountability Proven ability to collaborate effectively with:Clinical Documentation Integrity (CDI)Health Information Management (HIM)Revenue IntegrityBilling OperationsInformation Technology (IT) Executive-ready communication skills, including:Written communicationVerbal communicationFacilitation and presentation skills Strong change leadership and continuous improvement mindset driven by data and performance outcomes. Demonstrated performance management discipline, including:Key Performance Indicators (KPIs)Operational cadenceAccountability frameworks Experience providing enterprise coding governance leadership across complex healthcare organizations. Strong operational discipline balancing:ProductivityCoding qualityCompliance risk management Deep knowledge of:ICD-10-CMICD-10-PCSCPT codingHCPCS codingModifier assignment guidelines Strong command of:Official coding guidelinesGovernment and commercial payer policiesRegulatory coding requirements Expertise in:MS-DRG reimbursement methodologiesAPC/OPPS reimbursement logicFacility coding requirementsProfessional coding conventions Extensive knowledge of:Coding quality assurance programsCoding audit practicesAudit defense preparationCoding-related denial prevention and resolution Working knowledge of:National Correct Coding Initiative (NCCI) editsClaim edit processesPre-bill hold conceptsRevenue cycle claim validation workflows Proficiency with:Encoder softwareComputer-Assisted Coding (CAC) platformsWork queue management systemsCoding analytics toolsReporting platforms Strong analytical, organizational, compliance, and leadership skills with a focus on operational excellence, coding accuracy, and regulatory integrity.