Job description

Experience:

10–15 years of experience in US Healthcare Medical Coding, Coding Quality, Auditing, or Payment Integrity.
Strong experience managing coding quality programs across multiple specialties and/or complex healthcare processes.
Proven experience in client management, quality governance, process improvement, and operational transformation.
Experience with coding audits, root-cause analysis, quality analytics, performance benchmarking, and corrective action planning.
Experience leading large teams and mentoring coding auditors, SMEs, and quality professionals.
Exposure to Lean/Six Sigma, automation, analytics, and technology-enabled quality improvement initiatives is preferred.

Drive coding quality governance and process management to consistently meet or exceed client SLAs, quality targets, and contractual requirements.
Partner extensively with clients to understand coding requirements, establish quality benchmarks, define performance baselines, and set appropriate quality targets.
Develop and execute coding quality strategies, audit frameworks, and continuous improvement programs aligned with client and business objectives.
Lead root-cause analysis of coding errors and drive corrective and preventive actions to improve accuracy and reduce repeat defects.
Oversee quality dashboards, trend analysis, sampling methodologies, audit outcomes, and performance reporting to identify improvement opportunities.
Act as the key business interface between client quality/transformation teams and EXL Operations, Quality, Analytics, Technology, and Transformation teams.
Build strong relationships with key client stakeholders and influence decision-making through data-driven insights and quality improvement recommendations.
Drive standardization and adoption of coding best practices across processes, specialties, and client engagements.
Promote a Lean Six Sigma culture and use quality tools and methodologies to improve process efficiency, accuracy, and customer outcomes.
Mentor and develop quality leaders, auditors, SMEs, and Lean Six Sigma professionals to build a strong quality capability.
Lead quality transition and implementation activities for new processes, including requirement gathering, quality framework design, audit plan development, and implementation support.
Ensure coding quality programs comply with client requirements, internal governance standards, regulatory guidelines, and relevant industry/certification requirements.
Identify opportunities for automation, analytics, AI, and technology-enabled quality improvements in coding processes
Support RFP/RFI responses, solutioning, and business development initiatives by providing coding quality expertise, metrics, governance models, and transformation case studies.
Participate in client visits, governance forums, and executive discussions to showcase quality performance, improvement initiatives, and transformation outcomes.
Facilitate knowledge sharing and benchmarking of coding quality practices across EXL and the broader healthcare industry.
Drive a culture of accountability, continuous improvement, and customer-centricity across the coding quality organization

Bachelor’s degree in Life Sciences, Healthcare, Nursing, or a related discipline.
Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent coding certification preferred.
Lean Six Sigma certification (GB/BB) preferred.
Strong knowledge of ICD-10-CM, CPT, HCPCS, NCCI, CMS guidelines, payer policies, and applicable coding regulations.

Communication Skill: Must have excellent communication and interpersonal skills

Working Hours: Mid shift

Work Model: Hybrid - Should be able to work from office at least for the first 6 months.

Telecommuter/Internet requirements, if applicable:

Wi-Fi with excellent bandwidth, uninterrupted power (power back up)

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