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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in managing coding quality programs, implementing Lean Six Sigma methodologies, and ensuring compliance with healthcare coding regulations. Proven ability to lead teams, drive process improvements, and foster client relationships through data-driven insights.
Highest-signal resume keywords
US Healthcare Medical CodingCoding Quality ManagementLean Six Sigma MethodologiesClient ManagementCoding Audits
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 Quality GovernanceRoot-Cause AnalysisQuality AnalyticsPerformance BenchmarkingCorrective Action PlanningProcess ImprovementQuality ReportingAutomationData-Driven InsightsContinuous Improvement
Soft Skills
Excellent CommunicationInterpersonal SkillsMentoringRelationship BuildingInfluencing Decision-Making
Tools & Technologies
Quality DashboardsAudit FrameworksPerformance Reporting ToolsAnalytics ToolsTechnology-Enabled Quality Improvements
Certifications & Qualifications
Certified Professional Coder (CPC)Certified Coding Specialist (CCS)Lean Six Sigma Certification (GB/BB)
Industry Keywords
ICD-10-CMCPTHCPCSNCCICMS GuidelinesPayer PoliciesHealthcare RegulationsPayment IntegrityAuditingQuality Governance
About the role
Key responsibilities & impact- Drive coding quality governance and process management to consistently meet or exceed client SLAs, quality targets, and contractual requirements
- Partner with clients to understand coding requirements, establish quality benchmarks, define performance baselines, and set quality targets
- Develop and execute coding quality strategies, audit frameworks, and continuous improvement programs
- Lead root-cause analysis of coding errors and drive corrective and preventive actions
- Oversee quality dashboards, trend analysis, sampling methodologies, audit outcomes, and performance reporting
- Act as the key business interface between client quality/transformation teams and EXL Operations, Quality, Analytics, Technology, and Transformation teams
- Build relationships with client stakeholders and influence decision-making through data-driven insights
- Drive standardization and adoption of coding best practices across processes, specialties, and client engagements
- Promote Lean Six Sigma methodologies to improve process efficiency, accuracy, and customer outcomes
- Mentor and develop quality leaders, auditors, SMEs, and Lean Six Sigma professionals
- Lead quality transition and implementation activities for new processes
- Ensure coding quality programs comply with client requirements, internal governance standards, regulatory guidelines, and relevant industry/certification requirements
- Identify opportunities for automation, analytics, AI, and technology-enabled quality improvements
- Support RFP/RFI responses, solutioning, and business development initiatives with coding quality expertise
- Participate in client visits, governance forums, and executive discussions
- Facilitate knowledge sharing and benchmarking of coding quality practices
- Drive accountability, continuous improvement, and customer-centricity across the coding quality organization
Requirements
What you’ll need- 10–15 years of experience in US Healthcare Medical Coding, Coding Quality, Auditing, or Payment Integrity
- Strong experience managing coding quality programs across multiple specialties and/or complex healthcare processes
- Proven experience in client management, quality governance, process improvement, and operational transformation
- Experience with coding audits, root-cause analysis, quality analytics, performance benchmarking, and corrective action planning
- Experience leading large teams and mentoring coding auditors, SMEs, and quality professionals
- Exposure to Lean/Six Sigma, automation, analytics, and technology-enabled quality improvement initiatives is preferred
- Bachelor’s degree in Life Sciences, Healthcare, Nursing, or a related discipline
- Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent coding certification preferred
- Lean Six Sigma certification (GB/BB) preferred
- Strong knowledge of ICD-10-CM, CPT, HCPCS, NCCI, CMS guidelines, payer policies, and applicable coding regulations
- Must have excellent communication and interpersonal skills
- Should be able to work from office at least for the first 6 months
- Wi-Fi with excellent bandwidth and uninterrupted power/power backup
Benefits
Comp & perks- Hybrid work model
- Wi-Fi with excellent bandwidth
- Uninterrupted power/power backup
- Mid-shift work schedule