Job Description
Overview
The Sr. Director of Coding will be responsible for coordinating strategic efforts including identifying and implementing operational efficiencies, ensuring product quality and overall client alignment. This role will lead key aspects of the Risk Adjustment Coding area, including but not limited to ensuring overall end to end coding performance meets or exceeds client expectations. In addition to leading operations related to training, quality, and overall production, this role will be a key liaison working directly with clients and vendors.
Responsibilities
- Successfully direct and implement strategic efforts across Risk Adjustment coding operations programming to achieve goals and objectives.
- Ensure operations and production plans across training, production, and quality/audit meet client project timelines; identifying risks, and potential gaps in performance and proactively develop strategies to reduce them.
- Coordinate strategic efforts with Executive and Operational Departments with regards to client contracting and service level agreements.
- Analyze quality reports, key metrics, and SLAs to identify trends and continuous process improvement opportunities. Identify, design, and implement process redesigns.
- Work with the Coding & Clinical Validation executive team to oversee both onshore and offshore coding production and coding accuracy including the onshore management of staff, hiring, promoting, evaluating, training, disciplining, and mentoring at the client team level across multiple client teams as well as offshore and onshore vendor performance across the client base.
- Use data to monitor coding productivity and address concerns on any client team’s performance through meeting with the leadership and/or managers. This includes the continued refinement and use of monitoring tools as needed to track and monitor client and team performance and report the coding progress to leadership. Reviews and communicates internal system reports for all clients. These reports cross production and quality accuracy. Reports are reviewed daily, weekly, monthly, quarterly, and yearly as needed.
- Participates in production meetings to develop and execute both coding and quality production plans, including targeted audits. Communicates production plans and project priorities to the managers in preparation for onboarding and/or scheduling of client products.
- Participates in coding quality accuracy meetings. Analyzes data to identify accuracy trends and implement activities to affect change as needed. This includes auditing, mentoring, and focused training. Works closely with the Training team to ensure training is aware of trends.
- Work with all levels of leadership to resolve issues that impact coding production and for MRA, CRA, and Medicaid. This will involve working closely with other departments such as IT, Data Operations, Data Analytics, Trainers, and Human Resources.
- Attends client meetings with Client Services staff related to production and quality.
- Professionally communicates findings of non-compliance with Company coding standards and requirements and facilitates ongoing communications and efficient department operations upward to the SVP and downward to the manager(s).
- Special projects as assigned by VP.
- Hire, develop, coach, lead and retain top-tier talent, with a focus on building and improving a team and culture that implements best in class practices to support and drive high levels of internal and external customer satisfaction.
- Complete all responsibilities as outlined on annual Performance Plan.
- Complete all special projects and other duties as assigned.
- Must be able to perform duties with or without reasonable accommodation.
This job description is intended to describe the general nature and level of work being performed and is not to be construed as an exhaustive list of responsibilities, duties, and skills required. This job description does not constitute an employment agreement and is subject to change as the needs of Cotiviti and the requirements of the job change.
Qualifications
- Coding certification: RHIA, RHIT, CCS, CCS-P, CPC, CPC-H (nationally certified medical coder as certified by either AAPC or AHIMA). CRC a plus.
- BS Degree preferred. May be substituted for 10+ years of medical coding/record abstraction experience.
- 10+ years of HCC or Risk Adjustment experience.
- 5+ years’ experience managing both coding production and quality/audit staff.
- 3+ years in a leadership role with formal direct reports.
- 5+ years working in a client-facing role, deep understanding of business needs of our clients, including challenges they face and other industry trends occurring. Ability to translate these needs into concrete initiatives with strong business cases supporting decisions, including understanding of key specific user personas and their definitions of value.
- Ability to establish, monitor, and enforce staffing and production schedules for both coding and quality staff.
- Ability to use data to identify production and quality trends and collaborate with the managers and team leads to develop plans to affect change where needed.
- Act as a coding subject matter expert for client coding guideline development ensuring compliance and accuracy to utilize appropriate resources for Medicare, Medicaid, and Commercial Risk Adjustment as required.
- Excellent written and communication skills including coaching and interpersonal skills and client interaction.
- Analytical and critical thinking skills to understand data to influence decision-making.
- Highly proficient in computer applications and technology, with advanced Excel skills.
- Manage multiple client deliverables and competing deadlines simultaneously.
- Awareness and adherence to HIPAA privacy and security regulations.
- Minimal travel requirements.
- After hours and/or weekend work may be required when necessary for major deliverables/deadlines.
- Must have flexibility and willingness to participate in the work processes of an international organization, including conference calls scheduled to accommodate global time zones.
Mental Requirements:
- Communicating with others to exchange information.
- Assessing the accuracy, neatness, and thoroughness of the work assigned.
Physical Requirements and Working Conditions:
- Remaining in a stationary position, often standing or sitting for prolonged periods.
- Repeating motions that may include the wrists, hands, and/or fingers.
- Must be able to provide a dedicated, secure work area.
- Must be able to provide high-speed internet access/connectivity and office setup and maintenance.
- No adverse environmental conditions are expected.
Base compensation ranges from $147,000 to $183,000 per year. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs.
Cotiviti offers team members a competitive benefits package to address a wide range of personal and family needs, including medical, dental, vision, disability, and life insurance coverage, 401(k) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti. For information about our benefits package, please refer to our Careers page.
Date of posting: 7/28/2026
Applications are assessed on a rolling basis. We anticipate that the application window will close on 9/28/2026, but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected.
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Originally posted on Himalayas
