AGM - HIM Services - Quality

About the role

Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. ESSENTIAL DUTIES AND RESPONSIBILITIES: Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member's performance objectives as outlined by the Team Member's immediate Leadership Team Member. This role bridges the gap between executive strategy and front-line execution. This role directly oversees a team of Quality Auditors, ensures strict adherence to international coding standards, and acts as the project lead for implementing automation tools, such as AI-driven Computer-Assisted Coding (CAC).

Responsibilities

• Quality Assurance & Performance Management
• Daily QA Operations: Manage daily workflows for the medical coding quality audit teams across multiple specialties
• Accuracy Governance: Maintain and enforce transactional accuracy targets, ensuring the delivery team consistently meets or exceeds the client SLAs
• Feedback Loops: Establish structured feedback mechanisms to communicate audit findings to production managers, facilitating rapid, data-driven corrective actions.
• Process Transformation & Technology Execution
• Automation Deployment: Act as the hands-on project manager for deploying autonomous coding systems, CAC software, and workflow optimization tools.
• Workflow Optimization: Identify operational bottlenecks, eliminate redundancies, and apply Lean methodologies to reduce turnaround times and operational costs.
• Root-Cause Analysis: Perform deep-dive denial analyses and partner with the Training & Operations to deploy targeted remediation plans.
• Client & People Management
• SLA Compliance: Monitor, analyze, and present client-specific quality metrics, serving as the primary point of contact for routine quality reviews and audit rebuttals.
• Team Development: Recruit, mentor, and conduct performance appraisals for Quality Lead Auditors and Subject Matter Experts (SMEs).
• Required Qualifications
• Education & Certifications
• Degree: Bachelor's degree in Health Information Management (HIM), Life Sciences, Healthcare Administration, or a related field.
• Core Credentials: Must hold active certifications from AAPC or AHIMA :CPC (Certified Professional Coder) / CCS (Certified Coding Specialist)CIC (Certified Inpatient Coder) / COC (Certified Outpatient Coder) is preferred
• Process Certification: Lean Six Sigma Green Belt certification is highly desirable.
• Experience & Skills
• Domain Expertise: Minimum of 7-9 years of experience in healthcare revenue cycle management (RCM), with at least 4 years in a direct medical coding quality supervisory or management role.
• Tech Literacy: Strong operational experience working with major EHRs (Epic, Cerner), encoder software (3M), and automated billing/coding platforms.
• Leadership Scope: Proven track record of managing delivery teams within an offshore/onshore global delivery model.
• PHYSICAL DEMANDS:

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