Quality Manager – Surgery Auditing

Quality Manager – Surgery Auditing is responsible for leading surgery quality audits, ensuring compliance with coding standards and payer requirements. This role involves managing a team, reviewing audit outcomes, and driving continuous quality improvement initiatives. The manager will develop training materials, process manuals, and presentations to enhance team capability. Additionally, the role requires strong collaboration, analytical skills, and the ability to manage multiple priorities in a dynamic environment.

• Bachelor’s Degree in Nursing (B.Sc./M.Sc./Diploma Nursing preferred).
• Certifications required: CPC (Certified Professional Coder), CCS (Certified Coding Specialist), CIC (Certified Inpatient Coder).
• Minimum 10 years of experience in medical coding.
• Minimum 5 years of experience in surgery coding quality auditing.
• Strong understanding of payer processes related to surgery coding.
• Hands-on experience in quality auditing for surgical coding.
• Proficiency in Microsoft Office tools (Excel, Word, Outlook, PowerPoint).
• Exposure to 3M software and NLP tools.
• Strong project management, analytical, and multitasking skills.
• Excellent verbal and written communication skills.
• Experience in strategic management and performance benchmarking.
• Strong knowledge of surgical coding guidelines and clinical concepts.
• Ability to research coding updates and resolve coding-related issues.
• Flexibility and adaptability in a fast-paced work environment.
• Training from office is mandatory; full-time role (40 hours per week).

• Manage and lead the surgery coding quality auditing team to ensure high standards of accuracy and compliance.
• Perform and oversee surgical coding audits and reviews in alignment with payer guidelines.
• Develop training materials, process manuals, handbooks, and presentations for team development.
• Provide feedback, coaching, and performance monitoring for auditors and SMEs.
• Analyze audit results, benchmark performance, and implement quality improvement initiatives.
• Research and stay updated on coding guidelines, payer requirements, and surgery coding updates.
• Collaborate on automation initiatives, including use of NLP tools and data extraction solutions.
• Ensure timely communication, reporting, and escalation of issues to management.