3 jobs in IKS Health
Director - Quality (Medical Coding)
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Job Description
Position: Director - Quality (Medical Coding)
Reporting To: Vice President - Medical Coding (Quality and Training)
Department: Medical Coding – Quality & Compliance
Profile Description
This role is responsible for defining and driving the quality strategy across one or more medical coding portfolios while ensuring coding accuracy, regulatory compliance, client satisfaction, and continuous process improvement. The Director – Quality will lead enterprise quality initiatives, strengthen audit governance, partner with Operations and Training teams, and leverage analytics to improve coding quality, reduce denials, and enhance client outcomes. The role is also responsible for ensuring compliance with industry standards, payer guidelines, and organizational quality frameworks.
Key Responsibilities
Process
- Own the Quality Management System (QMS) across assigned coding portfolios and ensure consistent execution of quality processes.
- Establish and maintain coding quality standards aligned with ICD-10-CM, CPT, HCPCS, payer policies, CMS guidelines, NCCI edits, and specialty-specific coding requirements.
- Drive achievement of internal and client-defined quality SLAs across all accounts.
- Develop audit methodologies including concurrent, retrospective, prospective, focused, and validation audits.
- Ensure calibration across Quality, Operations, Training, and Client teams through standardized audit guidelines.
- Lead root cause analysis (RCA) for quality defects and implement effective corrective and preventive actions (CAPA).
- Monitor coding trends, denial trends, payer edits, and regulatory updates to proactively mitigate quality risks.
- Drive continuous process improvement initiatives through Lean, Six Sigma, and automation opportunities.
- Standardize quality scorecards, audit tools, and governance dashboards across portfolios.
- Ensure readiness for client audits, internal audits, compliance reviews, and external accreditation requirements.
- Establish governance around coding policy changes and ensure timely implementation across operations.
People
- Build and lead a high-performing Quality organization across multiple coding specialties.
- Coach and mentor Quality Managers and Leads to improve audit effectiveness and leadership capabilities.
- Develop competency frameworks for auditors and quality professionals.
- Partner with Operations and Learning teams to identify knowledge gaps and implement targeted training interventions.
- Drive certification programs (AAPC/AHIMA), continuing education, and ongoing competency assessments.
- Promote a culture of quality ownership across Operations rather than quality inspection.
- Drive employee engagement, succession planning, talent retention, and career development within the Quality function.
- Conduct regular calibration sessions to ensure inter-auditor reliability and consistency.
- Foster innovation by encouraging adoption of AI-assisted quality monitoring and analytics.
Client
- Serve as the Quality leader during client governance meetings including Weekly Business Reviews (WBRs), Monthly Business Reviews (MBRs), and Quarterly Business Reviews (QBRs).
- Present quality performance, audit findings, denial trends, and improvement initiatives to clients.
- Build trusted client relationships through proactive communication and consultative quality leadership.
- Partner with client coding compliance teams to resolve coding interpretation differences.
- Support client onboarding, transitions, and implementation activities by establishing quality governance.
- Lead provider education initiatives arising from coding audit findings when required.
- Ensure client quality KPIs, contractual obligations, and compliance expectations are consistently achieved.
Financial
- Improve client ROI by reducing coding defects, rework, denials, and revenue leakage.
- Partner with Operations leadership to improve first-pass quality and operational efficiency.
- Support account profitability by minimizing quality-related cost of poor quality (COPQ).
- Measure and report financial impact of quality improvement initiatives.
- Participate in business reviews and support strategic growth opportunities through quality excellence.
- Drive automation initiatives that improve audit efficiency and reduce manual effort.
Governance & Compliance
- Ensure compliance with HIPAA, CMS regulations, payer-specific guidelines, OIG recommendations, and organizational policies.
- Monitor coding compliance risks and implement mitigation strategies.
- Lead internal compliance audits and support external regulatory audits.
- Maintain documentation supporting quality governance and audit readiness.
- Ensure timely dissemination and implementation of coding guideline updates.
Analytics & Continuous Improvement
- Develop executive dashboards highlighting quality trends, DPU, accuracy, denials, auditor agreement, productivity, and compliance metrics.
- Perform advanced trend analysis using audit data to identify systemic process improvements.
- Utilize statistical quality control techniques and predictive analytics to improve coding performance.
- Lead enterprise quality transformation initiatives leveraging AI and automation.
- Benchmark organizational performance against industry standards and best practices.
Qualifications
- Graduate in any discipline is mandatory.
- BPT, MPT, B.Sc Nursing, M.Sc Nursing, B.Pharm, M.Pharm, BOT, or Life Sciences preferred.
- AHIMA or AAPC certification (CPC, CCS, CCS-P, CIC, CRC or equivalent) is mandatory.
- Lean Six Sigma Green Belt or Black Belt preferred.
- MBA or Master's degree in Healthcare Administration or Quality Management will be an added advantage.
- MBBS, BDS, BAMS, BHMS, or other healthcare professional qualifications would be an added advantage.
Role Prerequisites
- 14+ years of experience in Medical Coding with significant leadership experience in Coding Quality and Compliance.
- Minimum 5 years of managing enterprise quality programs across multiple specialties and clients.
- Extensive experience in coding audits, coding compliance, provider education, and denial prevention.
- Strong understanding of US healthcare regulations, payer policies, CMS guidelines, and coding compliance.
- Experience in leading quality transformation initiatives across large teams (300+ FTE preferred).
- Demonstrated experience working with executive leadership and external clients.
- Experience in AI-enabled quality assurance, analytics, or automation initiatives is preferred.
Functional Competencies
- Expert knowledge of ICD-10-CM, CPT, HCPCS, CMS Guidelines, and NCCI edits.
- Expertise across multiple coding specialties.
- Advanced coding audit methodology and compliance knowledge.
- Strong understanding of revenue cycle management and denial prevention.
- Root Cause Analysis (RCA) and Corrective & Preventive Action (CAPA).
- Statistical quality analysis and performance analytics.
- Governance reporting and executive dashboard preparation.
- Lean Six Sigma process improvement methodologies.
- Client relationship and stakeholder management.
- Strong presentation and communication skills.
- Advanced Microsoft Excel, Power BI, and Microsoft Office/G-Suite proficiency.
- Knowledge of AI-assisted coding validation and quality monitoring tools is preferred.
Behavioral Competencies
- Accountability
- Customer Service Orientation
- Strategic Thinking
- Developing Others
- Coaching and Mentoring
- Collaboration
- Analytical Thinking
- Decision Making
- Continuous Improvement Mindset
- Communication and Executive Presence
- Change Leadership
- Innovation
- Influence without Authority
Key Success Metrics (KPIs)
- Coding Quality Accuracy (%)
- Defect Per Unit (DPU)
- First Pass Yield (FPY)
- Coding-related Denial Rate
- Audit Completion SLA
- Auditor Agreement / Calibration Score
- Corrective Action Closure Rate
- Client CSAT / Quality Satisfaction Score
- Regulatory Compliance Score
- Cost of Poor Quality (COPQ)
- Revenue Leakage Prevented
- Training Effectiveness Score
- Quality Improvement Project Savings
- Employee Engagement & Attrition within Quality Organization
The competencies highlighted under Functional and Behavioral Competencies are mandatory and would be assessed during the hiring and selection process. This role is expected to act as the enterprise Quality leader for Medical Coding by partnering with Operations, Training, Technology, and Client Leadership to build a culture of continuous quality improvement, compliance excellence, and operational effectiveness.
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Senior Vice President Operations
Posted 6 days ago
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Job Description
About IKS Health IKS Health enables the enhanced delivery of exceptional healthcare for today’s practicing clinicians, medical groups and health systems. Supporting healthcare providers through every function of the patient visit, IKS Health is a go-to resource for organizations looking to effectively scale, improve quality and achieve cost savings through integrated technology and forward-thinking solutions. Founded in 2007, we have grown a global workforce of 14,000 employees serving over 150,000 clinicians in many of the largest hospitals, health systems, and specialty groups in the United States. IKS Health revitalizes the clinician-patient relationship while empowering healthcare organizations to thrive. We take on the chores of healthcare — spanning administrative, clinical, and operational burdens — so that clinicians can focus on their core purpose: delivering great care. Combining pragmatic technology and dedicated experts, our solutions enable stronger, financially sustainable enterprises.
By bringing joy and purpose back to medicine, we’re creating transformative value in healthcare and empowering clinicians to build healthier communities.
Vision: Healthier Communities, Happier Clinicians, Thriving Organizations, Successful Healthcare for all.
Mission: Our mission is to enable the efficient delivery of excellent care. We will deliver on this promise in a manner that makes it a joy for all to work with us; becoming the trusted partner that ensures financial success for our clients and healthier populations in our communities.
What We Do
Revenue Optimizations Services : Our purpose built Revenue Optimization Services reduces administrative burden, maximizes revenue and enables growth at scale while using a variable cost model. Delivered using a technology led platform we transform revenue cycle management, prevent denials, facilitate the patient-provider care journey and maximize contract utilization.
Clinical Support Solutions: Our Clinical Support Solutions help providers deliver better clinical outcomes, more efficient care, reduce clinician burnout and lower medical costs, resulting in improved physician and patient satisfaction as well as increased enterprise value. All of this while restoring the primacy of the physician-patient relationship in the exam room & beyond.
Value Based Care : As insurance reimbursement models move towards paying for outcomes, managing population health holistically becomes more important for provider enterprises. Our value-based care solutions allow provider enterprises to succeed across the spectrum of risk by building a patient-centric, provider-led delivery model that coordinates care across the continuum and delivers better clinical, operational and financial outcomes.
Digital Health Solutions : Our Digital Health Solutions are a robust platform that delivers data-driven value and expertise across the care continuum. It enables provider enterprises to leverage the full potential of their technology assets by helping them build, enhance, maintain and support these critical parts of their IT infrastructure. From a Unified Data Platform to Robotic Process Automation and creating bespoke technology solutions, IKS Health’s Digital Health Solutions help solve some of provider enterprises biggest challenges.
Tech Engineering : Our Tech Engineering is dedicated to crafting cutting-edge software products and shaping digital customer experiences through our next-generation Care Enablement Platform. Our focus spans across various domains within technology, offering a diverse range of opportunities in Technical Program Management, Software & Product Engineering, Enterprise Architecture, Service Engineering, Interoperability, Test & Process Automation, Data Engineering, Data Science, BI Reporting, and Data Analytics—all hosted on the cloud. Our commitment lies in harnessing the latest advancements in technology to create solutions that transcend traditional boundaries, fostering a dynamic ecosystem where technology intersects seamlessly with healthcare to drive positive change.
POSITION DETAILS
Position: Senior Vice President
Location: Mumbai
Reporting To: BU Head
Qualification: Lifesciences / Clinical degree/ MBA (Preferred)
- 20+ years of experience working in healthcare with a strong understanding of provider industry
- Proven track record of managing business unit / vertical that has teams across geographies, driving results and progressive leadership experience
- Successfully driven operations with focus on ensuring customer satisfaction, operational efficiency and technology driven transformation
- Spearheaded initiatives around people, process and technology for the business to operate efficiently impacting the bottom line and provide the necessary support to support top line growth
- Degree in Management from a premier institute preferred but not mandatory
- Experience in working in hyper-growth environment and ability to deliver solutions through structured problem solving
- Demonstrated ability to show thought leadership and drive consultative conversations with executive leadership
- Familiar with Healthcare Revenue Cycle Management and Clinical workflows along with knowledge of Practice Management Systems (Good to have)
- Self-driven and proactive with ability to multi-task and prioritize issues in a complex environment.
- Project management, implementation, planning and organizational skills
- Excellent verbal and written communication skills
- Excellent organization, motivation, leadership, and interpersonal skills
- Ability to travel as needed
CHALLENGES
SVP, Operations is a key leadership position and an important enabler to IKS Health’s endeavor of delivering best in class delivery to our healthcare clients that are leading physician groups and provider organizations. This role will lead the Delivery organization to ensure operational excellence with high levels of customer satisfaction. The role requires extensive collaborations with functional departments across IKS including but not limited to Sales, Product Development, Technology, Finance and Workforce Management. This role might require travel regularly within India and to the US 3-4 times a year that includes spending time at customer locations.
RESPONSIBILITIES
- Lead the Business Unit Operation s and manage capabilities such as Medical Coding, Clinical Data Management and Patience Access to ensure high levels of customer satisfaction, employee engagement and operational excellence
- Take end-to-end ownership of operations , delivering services that are aligned to meet customer goals and success including contractual commitments
- Manage the P&L to drive financial performance that meets and exceeds budgets; actively participate in the annual budgeting and monthly forecasting process
- Be a key leader to drive financial improvement (with a goal to achieve 2X over the next 5 years) through initiatives that impact both top line growth and bottom line profitability
- Closely monitor customer, financial and operational metrics at the overall business and account level to ensure the set targets are met. Proactively identify if there is a slack or an improvement, devise a plan and execute it by working closely with the delivery team and other enabling functions
- Serve as a key senior client liaison with deep & meaningful relationships in the client organization that enable successful long-term partnerships and business growth
- Work with the delivery leaders to resolve operational issues affecting the customer promptly and reporting performance metrics including economic value to the customer on a regular basis.
- Continuously look for transformation opportunities through technology (AI, Automation and any other modern technology solutions), process improvement and best practices
- Contribute to the business growth and strategy initiatives that will involve working with product leaders and market leaders in defining the GTM strategy for IKS products and solutions
- Work with delivery and HR teams to drive a robust people engagement plan that ensures overall development for all team members and establishes IKS as an employer of choice
- Mentor and coach direct reports to enable professional & personal growth. Developing, implementing & monitoring frameworks to elevate the human capital of the team
- Leverage understanding of industry best practices to assess existing internal and client processes and identify opportunities to enhance the quality of outcomes or efficiency of delivery including automation.
- Ensuring the resources are closely engaged and providing them a clearly defined career path while performance is meeting and exceeding the set targets.
Key Measurements of Success
- Ensure operational metrics with regards to ensuring SLAs are met and/or exceeded
- Ensure business metrics and value proposition is met and shared with the customer
- Ensure solutions meet customer needs and protect IKS interests
- Reduce provider escalations and ensure high levels of customer satisfaction and retention
- High employee engagement, satisfaction, and retention
- Ensure the customer will serve as a reference for IKS
- Support revenue growth for the customer
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Associate Vice President - Coding
Posted 6 days ago
Job Viewed
Job Description
About IKS Health
IKS Health enables the enhanced delivery of exceptional healthcare for today’s practicing clinicians, medical groups and health systems. Supporting healthcare providers through every function of the patient visit, IKS Health is a go-to resource for organizations looking to effectively scale, improve quality and achieve cost savings through integrated technology and forward-thinking solutions. Founded in 2007, we have grown a global workforce of 14,000 employees serving over 150,000 clinicians in many of the largest hospitals, health systems, and specialty groups in the United States.
IKS Health revitalizes the clinician-patient relationship while empowering healthcare organizations to thrive. We take on the chores of healthcare — spanning administrative, clinical, and operational burdens — so that clinicians can focus on their core purpose: delivering great care. Combining pragmatic technology and dedicated experts, our solutions enable stronger, financially sustainable enterprises. By bringing joy and purpose back to medicine, we’re creating transformative value in healthcare and empowering clinicians to build healthier communities.
Vision: Healthier Communities, Happier Clinicians, Thriving Organizations, Successful Healthcare for All.
Mission: Our mission is to enable the efficient delivery of excellent care. We will deliver on this promise in a manner that makes it a joy for all to work with us; becoming the trusted partner that ensures financial success for our clients and healthier populations in our communities.
Position: Associate Vice President_Coding
Reporting To: Vice President Department: Coding
Profile Description: The AVP of Coding will be responsible for ensuring that all operations of IKS Coding meet or exceed client requirements and are operationally efficient. This role will lead the Line of Business, collaborate with sales in building the business, manage the delivery of services, and the P&L. Key Measurements for the role will be Revenue, Gross Margin, and Customer Satisfaction
Key Responsibilities:
Process:
● Financial responsibility for each customer account assigned to the respective AVP (including managing SG&A and Gross margins)
● Manage the P&L Drive, sustain EBITDA
● Manage high Customer Satisfaction Level Participate in business development activity
● Independently manage large people accounts
● Manage all aspects of Delivery including recruiting, training, career mapping, quality & operational finance
● Be up to date with latest Technology
● Liaise with other functions across the Organization affecting technical support
● Assist Management in start-up of new projects
● Advise Management on exploring new business opportunities
● Contribute to the development of short and long term strategies business goals.
People:
● Support a positive culture and work environment that promotes IKS as an employer of choice.
● Lead by example – (courteous, energetic, punctual, and respectful, of others and team player)
● Commitment, Strategic Thinking, Effective People Management, open for suggestion, deliberate decisions
Client:
● Ensure the clients/customers satisfaction through the project implementation
● Coordinate with clients on a regular basis and build rapport with client with an objective to maintain fruitful relationship and reach business goals
● Play key role between client and the company
● Create appropriate servicing and retention strategies for customers
● Provide functional support and direction to the associates and team leaders on customer support needs
Financial:
● Vertical Revenue Management
● Vertical Margin & EBIDTA
● Cost Optimization
● Farming & New Revenue as per forecast
● Pricing & Contractual Revenue safeguard - Implementation & Minimum fees
Qualifications:
● Should be a graduate from any field.
● AHIMA/AAPC certification is a must
● BPT, MPT, BSC Nursing, MSC Nursing, B Pharm, M Pharm, BOT, Life Science would be preferred ● MBBS, BDS, BAMS, BHMS, BUMS etc would be an added advantage
Role Prerequisites:
● 14+ years experience in running core coding / related RCM operations including having significant experience in end to end Operations management, workflow assessments, onsite and remote client management is a must.
● Experience of managing and working on P&L of the business OR account is a must
Functional Competencies:
● Team player who can work with multi-geography cross-functional teams
● Consultative conversations with CXOs
● Ability to quickly build confidence & credibility with prospects, customers and internal team members
● Strong personal communication and presentation skills
● Create and manage operational frameworks to deliver high quality of work in the field of medical coding.
● Ability to lead and manage large teams and work with teams across continents
● Demonstrate ability to lead & motivate a team to achieve business goals
● Extremely high energy team player with a burning desire to succeed in fast paced environment and rapidly evolving market ● Demonstrate ability in managing client relationships ● Discuss business issues from both big picture and immediate day-to-day and use this to ● Articulate proposition, solution & partnership plans ● Demonstrate ability in managing processes at required margins
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