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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates extensive knowledge of ASC reimbursement methodologies, CPT, HCPCS, and ICD-10-CM coding, along with strong leadership in coding compliance and education. Capable of developing and implementing coding audit plans, corrective action strategies, and training programs to enhance coding accuracy and compliance.
Highest-signal resume keywords
CPT CodingHCPCS CodingICD-10-CM CodingCoding Compliance LeadershipRevenue Cycle Operations
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Coding AuditDocumentation RequirementsReimbursement ComplianceCoding Standards DevelopmentDenial Trend AnalysisCoding Education ProgramsCorrective Action PlansCoding Strategy DevelopmentMulti-Site ASC ExperienceCoding Quality Improvement
Soft Skills
LeadershipMentoringCommunicationCollaborationAnalytical Thinking
Tools & Technologies
Coding TechnologyComputer-Assisted CodingAnalytics ToolsAI ToolsAutomation Solutions
Certifications & Qualifications
CPCCPMACCSCCS-PRHIARHIT
Industry Keywords
Ambulatory Surgery CentersPayer RegulationsRevenue IntegritySurgical SpecialtiesCompliance Programs
About the role
Key responsibilities & impact- Lead the enterprise coding audit and compliance program for ambulatory surgery centers
- Develop annual coding audit plans based on financial risk, regulatory activity, payer trends, and organizational priorities
- Conduct and oversee audits focused on CPT, HCPCS, ICD-10-CM coding accuracy, documentation support, modifier usage, and reimbursement compliance
- Identify coding and documentation risks and develop corrective action plans with operational leaders
- Monitor and trend audit findings and provide regular reporting to executive leadership
- Support external audit preparedness and response involving CMS, Medicare Administrative Contractors, Recovery Audit Contractors, Targeted Probe and Educate, commercial payers, and other regulatory entities
- Serve as the enterprise expert on ASC reimbursement methodologies and specialty-specific coding requirements
- Develop and maintain coding standards and guidance across facilities
- Evaluate coding implications of new procedures, service lines, technologies, and physician recruitment initiatives
- Interpret and communicate changes in CPT coding, Medicare rules, payer policies, and industry regulations
- Identify coding-related reimbursement opportunities and risks with Revenue Integrity, Managed Care, and Revenue Cycle Operations teams
- Analyze denial trends and develop coding strategies to reduce preventable denials
- Evaluate payer edits, billing rules, and reimbursement patterns for compliant revenue optimization
- Support clean claim rates, coding accuracy, and reimbursement outcomes
- Develop and lead enterprise coding education programs
- Create and distribute coding guidance updates, newsletters, job aids, and educational materials
- Design targeted training plans based on audit findings, regulatory updates, and coding trends
- Support coder onboarding, competency assessments, and ongoing professional development
- Lead, mentor, and develop coding auditors, educators, and coding professionals
- Support coding standardization across the ASC platform
- Evaluate automation, technology, and AI-enabled solutions to improve coding quality and audit effectiveness
- Participate in strategic revenue cycle and operational initiatives supporting organizational growth and performance
Requirements
What you’ll need- Bachelor's degree or equivalent experience may be considered
- Minimum 10 years of progressively responsible coding, compliance, revenue integrity, or coding audit experience
- Minimum 5 years of leadership experience in coding compliance, coding quality, audit, or education functions
- One or more required certifications: CPC, CPMA, CCS, CCS-P, RHIA, or RHIT
- Extensive knowledge of ASC reimbursement methodologies
- Extensive knowledge of CPT coding
- Extensive knowledge of HCPCS coding
- Extensive knowledge of ICD-10-CM
- Extensive knowledge of NCCI edits
- Extensive knowledge of Medicare and commercial payer regulations
- Extensive knowledge of documentation requirements
- Extensive knowledge of revenue cycle operations
- Experience presenting complex coding and compliance findings to operational and executive leadership
- Multi-site ASC experience preferred
- Experience supporting high-volume surgical specialties preferred
- Experience leading coding education and compliance programs across geographically dispersed organizations preferred
- Experience with coding technology, computer-assisted coding, analytics, and AI tools preferred
- Experience partnering with physician practices and surgery center operations preferred
Benefits
Comp & perks- Paid Time Off
- 9 observed holidays
- Paid family leave
- Medical insurance
- Dental insurance
- Vision insurance
- Life insurance
- Disability insurance
- Healthcare FSA
- Dependent Care FSA
- Limited Healthcare FSA
- Transportation and parking FSAs
- Health Savings Account (HSA)
- Matching 401(k) plan
- Training and professional growth opportunities
- Recognition opportunities