Define and maintain the master coding manual for SNF (PDPM), Home Health (PDGM), and LTC.
Design the standardized workflows that all delivery teams must follow to ensure consistency.
Create solution accelerators (templates, query forms, and checklists) to be used across the enterprise.
Design the Audit Framework (the "scorecard") used to measure coding accuracy.
Perform high-level "Audit of the Auditors" to ensure that quality standards are being applied consistently across different teams.
Lead Root Cause Analysis (RCA) when accuracy drops below 95%, and design the corrective action plan for the operational teams to execute.
Develop the Curriculum and Certification requirements for all new hires in the post-acute space.
Conduct "Train-the-Trainer" sessions for operational leads to ensure they understand new CMS regulations or payer policies.
Serve as the SME for complex coding "gray areas" where delivery teams need a definitive ruling.
Act as the Functional Owner for coding software (e.g., Epic, CAC, AI tools).
Collaborate with IT to optimize EHR templates and ensure that automated coding tools are capturing the correct clinical triggers for reimbursement.
Key Success Indicators/Attributes
Strong analytical, critical thinking, and problem-solving capabilities.
Ability to collect, research, and synthesize complex and diverse information.
Excellent written, verbal and presentation skills.
Ability to build and maintain trust-based relationships with internal and external stakeholders.
Strong customer service orientation with a professional demeanor.
Demonstrated leadership and mentoring capabilities.
Able to prioritize and multi-task effectively in a complex, fast-paced environment.
Self-motivated with the ability to set goals, meet deadlines, and lead cross-functional initiatives.
Positive, adaptable, and able to support team decisions and organizational goals.
Supervisory Responsibility
None.
Work Environment
This job operates in a remote home office environment. This role routinely uses standard office equipment such as computers and phones.
Physical Demands
The physical demands described here are representative of those that must be met by an employee to
successfully perform the essential functions of this job.
While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; and talk or hear. The employee must occasionally lift or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, peripheral vision, depth perception and the ability to adjust focus.
Position Type/Expected Hours of Work
This is a full-time position. Days and hours of work are generally Monday through Friday, 8:00 a.m. to 5 p.m. This position occasionally requires long hours and weekend work.
Travel
Minimal travel up to 5%.
Other Duties
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. Employee may perform other duties as assigned.
Founded in 2003, Omega Healthcare Management Services (Omega Healthcare) empowers healthcare to thrive via intelligent solutions that optimize revenue cycle operations, administrative workflows, care coordination, and clinical research on a global scale. The company works with providers, payers, life science companies, medical device manufacturers, health technology firms, researchers, and industry partners to amplify teams with robust technology, specialty expertise, and operational support. Omega Healthcare serves more than 350 healthcare organizations with 35,000 skilled workers in the United States, India, Colombia, and the Philippines. For more information, visit www.omegahms.com
AAP/EEO Statement
Omega Healthcare is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, gender, age, sexual orientation, gender identity or expression, marital status, mental or physical disability, protected veteran status, and genetic information, or any other basis protected by applicable law. Omega Healthcare also prohibits harassment of applicants or employees based on any of these protected categories.
Omega Healthcare makes reasonable accommodations when needed for applicants and candidates with disabilities or religious observances. If reasonable accommodation is needed to participate in the job application, interview, or any other part of the hiring process, please contact Human Resources at employeerelationsus@omegahms.com.
Required Education and Experience
10-12 years of progressive experience in medical coding, auditing, and compliance, specifically within Skilled Nursing Facilities, Home Health and Long-Term Care environments.
Proven success in client-facing roles such as pre-sales support, solution architecture, or functional delivery leadership within a BPO/outsourcing context.
Deep, hands-on knowledge of ICD-10-CM, CPT/HCPCS, MDS/RAI and PDPM models, OASIS-E and PDGM models, and survey readiness and documentation strandards.
Strong understanding of CMS regulations, payer policies, HIPAA compliance, and audit frameworks (RAC, MAC, ADR).
Active AHIMA (CCS, RHIA, RHIT) or AAPC (CPC) credentials.
Preferred Education and Experience
CDIP, CCDS, CRC, COQS, or equivalent credentials are a plus.
Clinical background with RN, PT, OT, or SLP licensure is preferred.
Knowledge of Inpatient Rehabilitation Facilities (IRF-PAI and CMG models).
| Location | FL |