Quality and Training Supervisor

Job Summary

The Quality and Training Supervisor plays a vital role in ensuring the accuracy, efficiency, and compliance of medical coding and billing processes. This role involves developing and delivering training programs, monitoring coding quality, and driving process improvements to enhance overall performance. The Quality Trainer will also support denial management efforts by analyzing claim denials and ensuring adherence to industry guidelines and best practices.

Job Responsibilities

• Develop and conduct training programs for medical coders, ensuring alignment with ICD-10-CM, CPT, HCPCS, and payer guidelines.
• Monitor, audit, and evaluate coding quality to ensure compliance with AAPC, AHIMA, and regulatory standards.
• Provide coaching and feedback to coding teams, helping improve accuracy and productivity.
• Assist in denials management, analyzing claim denials, identifying root causes, and developing corrective actions.
• Maintain up-to-date knowledge of coding guidelines, medical necessity requirements, and payer policies.
• Collaborate with leadership to enhance quality assurance programs and optimize training effectiveness.
• Develop training materials, job aids, and documentation to support continuous learning and improvement.
• Conduct regular audits to assess coding accuracy and compliance, providing reports and insights to leadership.
• Support new hires with onboarding training and ongoing skill development programs.
• Stay current with industry updates, regulatory changes, and best practices, incorporating them into training programs.

Job Requirements

• Active coding certification from AAPC or AHIMA (e.g., CPC, COC, CCS).
• 3-5 years of hands-on coding experience in professional coding and outpatient facility coding.
• 1-2 years of supervisory experience in Quality and Training within a Healthcare BPO environment.
• Strong expertise in ICD-10-CM, CPT, HCPCS, and medical necessity guidelines.
• Experience with claims analysis, denials resolution, and appeals processes.
• Excellent communication and presentation skills to deliver effective training.
• Strong analytical and problem-solving skills to identify trends and implement corrective actions.
• Proficiency in Microsoft Office (Excel, PowerPoint, Word) and coding software/tools.
• Ability to work independently and collaboratively in a fast-paced environment.