Director of Coding & CDI

AtlantiCare•Egg Harbor Township, NJ

3d•Onsite

About The Position

The Director of Coding and CDI will provide strategic leadership and operational oversight for system-wide documentation integrity and all inpatient and outpatient soft coding functions across acute and ambulatory settings. This role ensures clinical data accurately reflects patient complexity, supports appropriate reimbursement, and maintains strict compliance with federal, state, and payer regulations. Serving as a primary liaison between Revenue Cycle, Revenue Integrity, Physician Advisors, and Quality teams, the Director drives innovation, integrity, and performance improvement across the enterprise. The Director will have a deep knowledge of ICD-10-CM/PCS, CPT-4, HCPCS Level II, and applicable coding regulations. Strong understanding of healthcare reimbursement methodologies, revenue cycle operations, and payer contracting. Proficiency with EHR systems (Oracle) and CDI/coding technology platforms (3M, Nuance, Optum, etc.). They will need the ability to build collaborative relationships with clinical, operational, and executive stakeholders. The Director will need to be Proficient in data analysis tools and presenting performance dashboards to leadership.

Requirements

Bachelor’s degree in healthcare administration, Nursing, or Business/Finance required.
Coding, inpatient and outpatient certification and/or CDI certification required upon hire or transfer.
Inpatient Coding: CCS (AHIMA), CIC (AAPC)
Outpatient Coding: CCS-P (AHIMA), CPC, or COC (AAPC)
CDI: CDIP (AHIMA) or CCDS (ACDIS), CDEO (AAPC), CDEI AAPC)
Minimum 15 years leadership/management experience and of varied experience in acute hospital and outpatient surgical services, professional billing etc.
Excellent written and oral communication skills.

Nice To Haves

Master’s degree (MBA, MHA, or Organizational Leadership) preferred or in process.

Responsibilities

Define and monitor KPIs for inpatient, ambulatory surgery (ASC), and outpatient coding operations, including coding quality metrics and productivity benchmarks.
Manage all medical coding activities (ICD-10-CM/PCS, CPT-4, HCPCS) and oversee third-party or offshore coding vendors for contract compliance.
Leverage EHR (Oracle/Epic) and encoding platforms (Solventum/3M) to automate workflows and optimize DNFB management and charge capture.
Establish and maintain policies that uphold regulatory standards and safeguard data integrity within the EHR in alignment with AHIMA, ACDIS, and AAPC standards.
Lead enterprise-wide CDI efforts, including concurrent/retrospective reviews to support accurate DRG assignment, HCC capture, and quality reporting (Vizient, USNWR).
Drive the query management process inpatient and outpatient, tracking physician agreement rates and outcomes.
Partner with Physician Advisors, Surgeons, and Hospitalists to deliver education on medical necessity and CMS Conditions of Participation.
Focus efforts on moving inpatient accounts from Zero to One CC/MCC to accurately reflect patient severity prior to claim release.
Act as a bridge between clinical staff and management to align documentation with patient care goals.
Collaborate with Revenue Integrity and PA advisors to reduce clinical denials and improve hospital quality scores through clinical validation.
Support organizational goals by providing quality customer service, participating in performance improvement efforts and demonstrating a commitment to team work and cooperation.