Quality Manager Medical Coding

Calpion is an 18-year-old Dallas-headquartered technology firm that offers customers artificial intelligence solutions by building custom deep learning and machine learning algorithms, custom enterprise application development and maintenance, RPA solutions, cloud services, Salesforce consulting, customized invoice management software solutions, and other technology services. We also offer automated bot-driven medical billing services. Our healthcare offering includes a Salesforce platform-based practice management and billing software with automated patient e-statements and a payment portal. Designation: Quality Manager – Medical Coding Department: Quality Openings: 1 Position Experience: 10–15 Years Shift: Day Shift Reporting To: Director – Quality Job Summary The Quality Manager – Medical Coding will oversee and lead the Quality Assurance (QA) team to ensure coding accuracy, regulatory compliance, and adherence to client SLAs across multiple RCM projects. This role requires strong leadership, deep domain expertise in Hospital Facility and Professional (Physician) Coding, and a strategic mindset to drive continuous improvement and team development. Key Responsibilities Lead and manage a team of 100+ Quality Analysts across diverse RCM coding projects. Foster an inspiring and collaborative team environment with open communication. Plan and allocate QA capacity based on workload and project needs. Delegate responsibilities, establish clear timelines, and monitor performance. Coach, train, mentor, and guide QAs to enhance competency and productivity. Address team concerns, resolve conflicts, and ensure a healthy work environment. Recognize and reward high-performing team members. Quality Assurance & Compliance Ensure high-quality coding delivery aligned with client SLAs and industry guidelines. Implement and enhance the Quality Management System (QMS). Conduct regular quality reviews, including random audits of auditors. Perform root cause analysis (RCA) on audit findings and implement corrective actions. Identify knowledge gaps and drive structured action plans with Quality Leads & Operations. Monitor and publish performance metrics, KPIs, and quality trends. Process Excellence & Continuous Improvement Identify opportunities for process improvement and workflow optimization. Encourage innovation, automation, and best practices within the QA team. Collaborate with cross-functional leaders to strengthen quality delivery and compliance. Competency & Knowledge Requirements Strong expertise in RCM coding for Hospital Facility and Physician (Professional) Coding. In-depth knowledge of E&M, ED, Surgery, IVR, and UHDDS guidelines. Comprehensive understanding of Anatomy, Physiology, Pathophysiology, Pharmacology, and clinical documentation. Ability to interpret Operative Reports, ED charts, Surgery records, and complex documentation. Strong understanding of compliance risks: upcoding, downcoding, fraud/abuse, documentation inflation, HIPAA, CLIA. Excellent communication skills, analytical ability, and team-handling skills. Proficient in coding guidelines and audit methodologies. Preferred: Certified Professional Coder (e.g., CPC, CCS, CIC, COC, CCS-P). Notice Period: Immediate or Short Notice Preferred Salary: As per industry standards Skills: ED, E&M, Surgery, ASC #J-18808-Ljbffr Calpion Inc.