Associate Director of Billing & Coding

Associate Director of Billing & Coding Fully Remote • MSO Corporate 1000 - Stamford, CT 06905 Apply Overview Salary Range $113,200.00 - $169,800.00 Salary Level Management Position Type Full Time Job Shift Day Education Level High School or Equivalent Travel Percentage None Category Health Care Apply Description Who we are: Spire Orthopedic Partners is a growing national partnership of orthopedic practices that provides the support, capital and operational resources physicians need to grow thriving practices for the future. As a Management Services Organization (MSO), Spire provides the infrastructure for administrative operations that allows practices to operate at their highest level, so doctors can focus their efforts on what matters most – patient care. Headquartered in Stamford, Connecticut, the Spire network spans the Northeast with more than 165 physicians, 1,800 employees, 285 other clinical providers and 40 locations in New York, Connecticut, Rhode Island and Massachusetts. What you’ll do: The Associate Director, Billing and Coding is a hands-on operational leader responsible for overseeing the accuracy, timeliness, and integrity of professional coding and charge capture processes across the organization. This role directly manages coding and charge entry teams, monitors daily workflows, ensures compliance with regulatory standards, and drives measurable improvements in revenue integrity and clean claim performance.  The Associate Director actively reviews coding trends, resolves escalations, conducts audits, provides education and partners with clinical and operational leaders to reduce denials, prevent revenue leakage, and strengthen documentation practices.  Responsibilities/Duties: Directly oversee professional coding operations.  Ensure accurate CPT, HCPCS, and ICD-10 coding in accordance with payer and regulatory guidelines.  Monitor coding productivity and quality on a daily and weekly basis.  Conduct routine internal audits and address coding variances promptly.  Lead corrective action plans when audit results fall below target thresholds.  Stay current with CMS, payer, and specialty-specific coding updates.  Oversee timely and accurate charge entry for all clinical services.  Monitor lag days from date of service to claim submission.  Identify and resolve missing charges, interface errors, and documentation gaps.  Implement controls to reduce unbilled inventory and prevent revenue leakage.  Validate modifiers and ensure compliance with payer-specific billing rules.  Review work queues and charge edit reports daily.  Intervene directly in complex or high-risk coding scenarios.  Participate in denial root cause reviews related to coding or charge capture.  Collaborate with AR leadership to address downcoding, bundling, and medical necessity denials.  Monitor and reduce coding-related denial rates Conduct detailed vendor performance reviews, including QC results and productivity tracking.  Escalate deficiencies and require documented remediation plans.  Participate directly in operational calls to review aging, denials, and backlog.  Evaluate cost effectiveness and recommend insourcing when appropriate.  Directly manage coding supervisors, leads, and charge entry staff.  Set clear productivity and accuracy expectations.  Conduct performance reviews and coaching sessions.  Provide ongoing education and specialty-specific training.  Develop high-performing coders with expertise in complex surgical and procedural coding (if applicable).  Partner with physicians and practice leadership to improve documentation quality.  Work closely with Revenue Cycle leadership to improve clean claim rates.  Collaborate with IT on system edits, charge interfaces, and automation.  Support new service lines and acquisitions with coding setup and charge master validation.  Track and report on key performance indicators:  Coding accuracy rate  Productivity benchmarks  Charge lag days  Coding-related denial rate  Unbilled inventory  Provide monthly reporting and operational improvement plans to RCM leadership.  Qualifications Who you are: Bachelor’s degree or equivalent work experience.  CPC, CCS-P, or equivalent professional coding certification required.  5–8+ years of progressive coding experience, including leadership.  Experience in orthopedic, multi-specialty physician practices or large healthcare organizations.  Strong knowledge of payer reimbursement methodologies.  Experience managing high-volume professional coding environments.  Proficiency in EHR and practice management systems.  Strong technical coding expertise  Operational discipline and workflow management  Detail orientation  Regulatory compliance  Team leadership and accountability  Data-driven decision making  Problem-solving and escalation management  What we offer:  Excellent growth and advancement opportunities  Dynamic environment  Access to a diverse network of practitioners  Broad infrastructure of tools and programs to enhance the employee experience     Competitive Compensation  Generous PTO   Benefits package: health, dental, vision, 401(k), etc.  We are an equal-opportunity employer. Qualified Applicants are considered for positions and are evaluated without regard to actual or perceived race, color, creed, religion, national origin, ancestry, citizenship status, age, sex, or gender (including pregnancy, childbirth, and related medical conditions), gender identity or gender expression (including transgender status), sexual orientation, marital status, military service and veteran status, physical or mental disability, protected medical condition as defined by applicable state or local law, genetic information, or any other characteristic protected by applicable federal, state, or local laws and ordinances (referred to as “protected characteristics”).   The final pay offered to a successful candidate will be dependent on several factors that may include but are not limited to the type and years of experience within the job, the type of years and experience within the industry, education, etc.