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Short Hills, New Jersey, United States
Remote only
This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Program Director, Coding HB based in the United States.
The Program Director, Coding HB provides strategic and operational leadership for hospital coding, billing, and revenue cycle optimization programs. This senior-level role combines deep technical expertise with client relationship management to improve coding accuracy, reimbursement, compliance, and financial performance. The successful candidate will evaluate hospital operations, identify performance gaps, and implement scalable solutions that deliver measurable results. Working closely with hospital executives and cross-functional teams, the director will translate complex operational and financial challenges into practical improvement strategies. The role also oversees program implementation, performance analytics, quality assurance, and regulatory compliance across client engagements. This is a full-time remote opportunity for an experienced healthcare revenue cycle professional with strong leadership and project management capabilities.
Program leadership: Direct hospital coding and billing programs, develop strategies, workflows, performance standards, KPIs, and implementation plans, and establish scalable processes and best practices across multiple clients.
Hospital coding and billing operations: Serve as a subject matter expert in inpatient and outpatient coding and billing, assess operational workflows, analyze coding accuracy and productivity, and identify opportunities to improve reimbursement, compliance, charge capture, and claim submission.
Revenue cycle optimization: Evaluate coding, clinical documentation improvement (CDI), billing, denials, utilization management, and payer-related processes to reduce denials, prevent revenue leakage, accelerate reimbursement, and improve clean claim rates.
Client leadership: Act as a trusted advisor to hospital and healthcare clients, lead operational assessments and executive presentations, communicate actionable recommendations, manage escalations, and develop strong relationships with clinical, financial, coding, and revenue cycle stakeholders.
Analytics and reporting: Analyze operational and financial data, develop and interpret dashboards and performance reports, establish benchmarks and improvement targets, and translate trends in productivity, quality, denials, and reimbursement into actionable recommendations.
Implementation and project management: Lead coding, billing, and revenue cycle initiatives by developing project plans, timelines, milestones, and deliverables; coordinating cross-functional teams; managing implementation risks; and communicating progress to clients and leadership.
Quality, compliance, and audit: Ensure programs comply with applicable federal and state regulations, payer requirements, and client policies. Monitor coding quality, support audits, identify compliance risks, recommend corrective actions, and maintain appropriate documentation.
Leadership and team development: Mentor coding, billing, and revenue cycle professionals, establish performance expectations, support education and training initiatives, and promote accountability, continuous improvement, and high-quality client service.
Stakeholder collaboration: Work with coding, CDI, billing, denials, revenue integrity, utilization management, analytics, and other teams to develop integrated solutions and improve overall hospital revenue cycle performance.
Performance monitoring: Track results following implementation, evaluate progress against established targets, and recommend adjustments to sustain operational and financial improvements.
Education: Bachelor’s degree in Health Information Management, Healthcare Administration, Business, Finance, or a related field. Equivalent experience may be considered.
Professional experience: At least 7 years of progressive experience in hospital coding, billing, Health Information Management (HIM), revenue cycle, or healthcare financial operations.
Leadership experience: At least 3 years of leadership or program management experience, including the ability to guide complex projects and cross-functional teams.
Technical expertise: Strong knowledge of inpatient and outpatient hospital coding, billing, revenue cycle operations, payer requirements, and reimbursement methodologies.
Client-facing experience: Experience working with hospitals, health systems, healthcare clients, or physician organizations, with the ability to build productive relationships across clinical, operational, and executive teams.
Analytical capabilities: Demonstrated experience evaluating operational and financial performance, interpreting data, identifying improvement opportunities, and measuring the outcomes of process improvement initiatives.
Project management: Proven ability to lead revenue cycle or operational improvement projects, coordinate multiple stakeholders, manage timelines, and deliver measurable results.
Communication skills: Excellent written, verbal, presentation, and executive communication skills, including the ability to explain complex technical and financial topics clearly.
Preferred certifications: RHIA, RHIT, CCS, CPC, COC, or another relevant Health Information Management or coding certification.
Preferred technology experience: Familiarity with EPIC or other major electronic health record (EHR) platforms, encoder and computer-assisted coding (CAC) tools, CDI systems, billing and revenue cycle technologies, and Power BI or other healthcare analytics platforms.
Additional preferred experience: Background in hospital denials and appeals, revenue integrity, outsourced coding or revenue cycle organizations, or managing multi-client or national healthcare programs.
Regulatory and quality knowledge: Ability to monitor coding quality, understand compliance requirements, support audits, and recommend corrective actions when risks or performance gaps are identified.
Work arrangement: Remote.
Employment type: Full-time.
Location: Short Hills, New Jersey, with a remote work arrangement.
Compensation: Not specified in the provided job description.
Additional benefits: Healthcare coverage, paid time off, retirement plans, and other perks are not specified in the provided job description.
