Associate Director – Billing, Coding

Spire Orthopedic Partners

Associate Director overseeing billing and coding operations at Spire Orthopedic Partners. Ensuring compliance, accuracy, and efficiency in coding practices across the organization.

Posted 6/30/2026full-timeRemote • Connecticut • 🇺🇸 United StatesSenior💰 $113,200 - $169,800 per yearWebsite

About the role

Key responsibilities & impact

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.

Requirements

What you’ll need

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.

Benefits

Comp & perks

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.

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

CPT CodingHCPCS CodingICD-10 CodingCoding AuditsCharge Entry ManagementCoding Variance ResolutionCoding Denial ManagementPerformance TrackingOperational Improvement PlanningData-Driven Decision Making

Soft Skills

Detail OrientationTeam LeadershipProblem-SolvingAccountabilityCommunication

Certifications

CPCCCS-P