Director of Coding

About The Wilshire Group 

The Wilshire Group, a renowned boutique consulting firm in Los Angeles, specializes in revenue cycle optimization and fostering effective collaboration between operational and IT facets.  With a robust track record of aiding over 100 healthcare systems nationwide, our team thrives on professionalism, efficiency, and adaptability.

Our core values- professionalism, efficiency, and flexibility- underscore our commitment to creating an inclusive and dynamic workplace.  We embrace diverse narratives and believe in offering opportunities to exceptional individuals who bring their best to the table.

We are currently offering a contracted interim position at one of US News Best Hospitals 2022-23.  This position caters to top performers seeking a professional environment that acknowledges and values their dedication and proficiency.  While this role doesn’t offer benefits, it presents an opportunity to work within an organization that encourages talented individuals to surpass conventional boundaries.

Join us at The Wilshire Group, a place where talented professionals find a home to showcase their skills and contribute meaningfully to the healthcare landscape.

Why Wilshire? Employee Testimonial

“The number of RCM subject matter experts I get to work with each day is unreal.  Working alongside and as part of this team to help shape the RCM space is exciting.”-Patti Consolver, Director of Business Development 

This is a contracted position for 6+ months.  This positions offers 60% of fee sharing.  Equivalent to $75-$85 per hour.

Job Title: Director of Coding
Department: Health Information Management (HIM)
Location: Remote
Reports To: VP of Mid Revenue Cycle
Job Type: Contracted Working Full-Time Hours

Position Summary:

The Director of Coding is responsible for the strategic oversight, leadership, and management of the hospital’s coding operations. This role ensures accurate and compliant medical coding practices in accordance with federal and state regulations, payer requirements, and organizational standards. The Director will collaborate with cross-functional teams, including clinical documentation improvement (CDI), compliance, billing, and revenue cycle departments to optimize reimbursement and maintain data integrity.

This position requires experience in an academic hospital setting, a strong understanding of medical coding systems, and exceptional leadership and analytical skills.

Key Responsibilities:Leadership & Strategy:

• Lead and manage the coding team, including hiring, training, performance evaluations, and professional development.

• Establish and implement policies and procedures to ensure efficient, accurate, and compliant coding practices.

• Develop and execute strategic initiatives to improve coding quality, productivity, and financial performance.

• Collaborate with leadership teams to align coding operations with the hospital’s overall goals and objectives.

• Foster a culture of continuous improvement, accountability, and professional growth.

Operational Oversight:

• Ensure timely and accurate assignment of ICD-10-CM/PCS, CPT, and HCPCS codes for inpatient, outpatient, and professional services.

• Monitor and maintain compliance with federal, state, and payer-specific regulations and guidelines.

• Oversee regular coding audits to ensure accuracy and identify areas for improvement.

• Collaborate with the Clinical Documentation Improvement (CDI) team to enhance documentation and support appropriate code assignment.

• Manage coding-related systems and technology, including electronic health records (EHR), encoder tools, and reporting platforms.

Financial & Data Integrity:

• Ensure accurate code assignment for appropriate reimbursement and minimal denials.

• Monitor key performance indicators (KPIs), including case mix index (CMI), coding accuracy, and DNFB (Discharged Not Final Billed) metrics.

• Identify and address coding-related revenue cycle issues in collaboration with the finance and billing departments.

Compliance & Quality Assurance:

• Ensure coding practices adhere to HIPAA, CMS, OIG, and other regulatory standards.

• Partner with compliance teams to investigate and resolve coding discrepancies or concerns.

• Stay current with changes in coding regulations and industry best practices.

Qualifications:Education:

• Bachelor’s degree in Health Information Management, Health Administration, or a related field required.

• Master’s degree preferred.

Certifications:

• Required:

  • Certified Coding Specialist (CCS) OR Certified Inpatient Coder (CIC)

  • Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT)

• Preferred:

  • Certified Coding Manager (CCM) or Certified Professional Coder (CPC)

Experience:

• Minimum of 7-10 years of progressive coding experience, with at least 3-5 years in a leadership role within an academic hospital or large healthcare system.

• Proven experience managing inpatient and outpatient coding operations.

• Strong knowledge of CMS guidelines, DRG, APC, and OPPS payment methodologies.

• Familiarity with CDI processes, coding audits, and clinical reimbursement methodologies.

Skills & Competencies:

• Leadership: Proven ability to lead and develop high-performing teams.

• Technical Expertise: In-depth knowledge of medical coding systems, coding compliance, and revenue cycle management.

• Analytical Skills: Ability to interpret data, identify trends, and implement process improvements.

• Communication: Strong written and verbal communication skills, with the ability to collaborate effectively across departments.

• Problem-Solving: Skilled in identifying and resolving complex coding-related challenges.

• Technology: Proficiency in EHR systems (e.g., Epic, Cerner), coding software, and data reporting tools.

Work Environment:

• Remote or on-site work environment, depending on organizational needs.

• Occasional travel for conferences, audits, or system updates may be required.