Director, Coding

Locations: Gainesville, Florida

Categories: Professional-Non Clinical

Req : 67768

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.

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 billing
  • Epic
  • Coding quality programs
  • Denial management
  • Audit response processes
  • Regulatory 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 development
  • Staff coaching and succession planning
  • Performance management and accountability
• Proven ability to collaborate effectively with:
  • Clinical Documentation Integrity (CDI)
  • Health Information Management (HIM)
  • Revenue Integrity
  • Billing Operations
  • Information Technology (IT)
• Executive-ready communication skills, including:
  • Written communication
  • Verbal communication
  • Facilitation 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 cadence
  • Accountability frameworks
• Experience providing enterprise coding governance leadership across complex healthcare organizations.
• Strong operational discipline balancing:
  • Productivity
  • Coding quality
  • Compliance risk management
• Deep knowledge of:
  • ICD-10-CM
  • ICD-10-PCS
  • CPT coding
  • HCPCS coding
  • Modifier assignment guidelines
• Strong command of:
  • Official coding guidelines
  • Government and commercial payer policies
  • Regulatory coding requirements
• Expertise in:
  • MS-DRG reimbursement methodologies
  • APC/OPPS reimbursement logic
  • Facility coding requirements
  • Professional coding conventions
• Extensive knowledge of:
  • Coding quality assurance programs
  • Coding audit practices
  • Audit defense preparation
  • Coding-related denial prevention and resolution
• Working knowledge of:
  • National Correct Coding Initiative (NCCI) edits
  • Claim edit processes
  • Pre-bill hold concepts
  • Revenue cycle claim validation workflows
• Proficiency with:
  • Encoder software
  • Computer-Assisted Coding (CAC) platforms
  • Work queue management systems
  • Coding analytics tools
  • Reporting platforms
• Strong analytical, organizational, compliance, and leadership skills with a focus on operational excellence, coding accuracy, and regulatory integrity.