Quality Manager Medical Coding

About

Calpion is an 18-year-old Dallas-headquartered technology firm that offers customers artificial intelligence solutions by building custom deep learning and machine learning algorithms, custom enterprise application development and maintenance, RPA solutions, cloud services, Salesforce consulting, customized invoice management software solutions, and other technology services. We also offer automated bot-driven medical billing services. Our healthcare offering includes a Salesforce platform-based practice management and billing software with automated patient e-statements and a payment portal.

Along with being SOC-certified and HIPPA-compliant, we have:

• Certified experts in deep learning & machine learning to provide intelligent solutions for your business.
• Helped Fortune 500 companies build custom enterprise-level applications.
• Provide remote & accurate AutoCAD Drawing, Drafting, 2D &3D modeling, and design services.
• Strategic partnerships with Microsoft, Amazon, SAP, HP, Worksoft, Microfocus, Tricentis, etc.
• Partnered with UiPath to provide RPA solutions.
• We are headquartered in Dallas with multiple global Centers of Excellence around the industry.
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Focus: Healthcare, Logistics, Supply chain, Biotechnology, Hospitality, Manufacturing, and Airlines.
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Life at Calpion Inc.

Calpion offers a unique work environment that is both thrilling and enriching, fostering personal and professional growth. Our company is a hub of innovation, collaboration, and continuous learning, where we encourage our employees to adopt a positive mindset and strive for excellence.

At Calpion, you'll be part of a vibrant team that thrives on creativity and problem-solving. You'll have the chance to work on cutting-edge projects, harnessing the latest technologies and methodologies to deliver intelligent solutions that make a real difference for our clients.

Calpion prioritizes the well-being of its employees and fosters a supportive and inclusive culture that promotes work-life balance. If you are enthusiastic about joining a vibrant organization that values your input, Calpion is the ideal place to pursue your career goals.
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Designation: Quality Manager – Medical Coding

‍Department: Quality

‍Openings: 1 Position

‍Experience: 10–15 Years

‍Shift: Day Shift

‍Reporting To: Director – Quality

‍Location: Bangalore
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Job Summary

The Quality Manager – Medical Coding will oversee and lead the Quality Assurance (QA) team to ensure coding accuracy, regulatory compliance, and adherence to client SLAs across multiple RCM projects. This role requires strong leadership, deep domain expertise in Hospital Facility and Professional (Physician) Coding, and a strategic mindset to drive continuous improvement and team development.
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Key Responsibilities

Team Leadership & People Management

• Lead and manage a team of 100+ Quality Analysts across diverse RCM coding projects.
• Foster an inspiring and collaborative team environment with open communication.
• Plan and allocate QA capacity based on workload and project needs.
• Delegate responsibilities, establish clear timelines, and monitor performance.
• Coach, train, mentor, and guide QAs to enhance competency and productivity.
• Address team concerns, resolve conflicts, and ensure a healthy work environment.
• Recognize and reward high-performing team members.

Quality Assurance & Compliance

• Ensure high-quality coding delivery aligned with client SLAs and industry guidelines.
• Implement and enhance the Quality Management System (QMS).
• Conduct regular quality reviews, including random audits of auditors.
• Perform root cause analysis (RCA) on audit findings and implement corrective actions.
• Identify knowledge gaps and drive structured action plans with Quality Leads & Operations.
• Monitor and publish performance metrics, KPIs, and quality trends.
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Process Excellence & Continuous Improvement

• Identify opportunities for process improvement and workflow optimization.
• Encourage innovation, automation, and best practices within the QA team.
• Collaborate with cross-functional leaders to strengthen quality delivery and compliance.
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Competency & Knowledge Requirements

• Strong expertise in RCM coding for Hospital Facility and Physician (Professional) Coding.
• In-depth knowledge of E&M, ED, Surgery, IVR, and UHDDS guidelines.
• Comprehensive understanding of Anatomy, Physiology, Pathophysiology, Pharmacology, and clinical documentation.
• Ability to interpret Operative Reports, ED charts, Surgery records, and complex documentation.
• Strong understanding of compliance risks: upcoding, downcoding, fraud/abuse, documentation inflation, HIPAA, CLIA.
• Excellent communication skills, analytical ability, and team-handling skills.
• Proficient in coding guidelines and audit methodologies.
• Preferred: Certified Professional Coder (e.g., CPC, CCS, CIC, COC, CCS-P).
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Additional Details

Notice Period: Immediate or Short Notice Preferred

Salary: As per industry standards

Skills: ED, E&M, Surgery, ASC
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Our Culture & Values

At Calpion, we're not just a company—we're a dynamic culture fueled by six core values: Agile, Collaborative, Innovative, Fun, Inclusive, and Passionate. These values drive our every move:

• Agile: We thrive on change, adapting swiftly to new challenges.
• Collaborative: Together, we achieve greatness through teamwork and diverse perspectives.
• Innovative: We push boundaries, constantly exploring new ideas and solutions.
• Fun: Laughter and camaraderie make our workplace a joyous one.
• Inclusive: Diversity is our strength, ensuring every voice is heard and valued.
• Passionate: We approach every task with dedication and enthusiasm.
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Join us at Calpion and be part of a culture that's not just about work but innovation, growth, and making an impact.