Director of Coding Compliance

Essen Health Care is the largest privately held, multispecialty medical group in New York, providing high-quality, compassionate care to some of the state’s most vulnerable and underserved residents.

Founded in 1999, we’ve grown from a single primary care office into a network of 50+ locations offering urgent care, primary care and specialty services, from women’s health to endocrinology and psychiatry. We also provide nursing home support, care management, and in-home care through our Essen House Calls program. Guided by a Population Health model, our team of 500+ providers deliver care in-person, at home, or via telehealth, ensuring patients get the support they need when and where they need it.

We’re looking for talented, motivated individuals to join our growing team. Whether you’re a medical provider, administrator, or operations professional, there’s a career here for you. Join us in making a real difference in the health of our community.

• →Conduct complex coding audits and documentation reviews for accuracy, completeness, and regulatory compliance.
• →Review ICD-10-CM, CPT, HCPCS, and risk adjustment coding to ensure alignment with CMS and payer guidelines.
• →Identify coding trends, compliance risks, and opportunities for operational improvement.
• →Partner with Compliance, SIU, Clinical Operations, Provider Education, and RCM teams to support organizational initiatives.
• →Develop and deliver provider and staff education related to coding accuracy and compliance standards.
• →Monitor regulatory changes and communicate impacts to leadership and operational teams.
• →Assist with internal and external audit preparation, corrective action plans, and regulatory responses.
• →Support oversight activities related to FWA (Fraud, Waste, and Abuse) prevention and documentation integrity.
• →Analyze audit findings and prepare detailed reports, dashboards, and executive summaries.
• →Serve as a subject matter expert for coding compliance and regulatory requirements.

• Certified Professional Coder (CPC) certification required.
• Minimum 7–10 years of medical coding and compliance auditing experience.
• Minimum 5 years of experience within a health plan, managed care organization, or payer environment.
• Strong knowledge of CMS regulations, Medicare Advantage, NYS Medicaid, HEDIS, and risk adjustment methodologies.
• Extensive experience with ICD-10-CM, CPT, and HCPCS coding systems.
• Knowledge of healthcare compliance standards and regulatory requirements.
• Experience conducting coding audits and developing corrective action plans.
• Strong analytical, communication, and leadership skills.
• Proficiency with coding and audit software applications and Microsoft Office Suite.

• CRC, CPMA, CCS, or other advanced coding/audit certification preferred.
• Experience supporting delegated vendor oversight and regulatory audits.
• Knowledge of NCQA standards and healthcare quality programs.
• Bachelor’s degree in Health Information Management, Healthcare Administration, Nursing, or related field preferred.

• Regulatory Compliance
• Risk Assessment
• Medical Coding Expertise
• Audit & Monitoring
• Provider Education
• Cross-Functional Collaboration
• Strategic Problem Solving
• Data Analysis & Reporting

• Onsite - Bronx, New York Office Monday - Friday