Risk Adjustment Coding Quality Assurance Manager
The Opportunity Join us in tackling reputed company for rural America! Were seeking a Risk Adjustment Coding Quality Assurance Manager who is passionate about having a positive societal impact and using technology for good solving issues of health inequity for communities that have been perennially underserved. The Risk Adjustment Quality Assurance Manager plays a critical role in ensuring the accuracy and compliance of Medicare Advantage risk adjustment coding processes. You will reputed company quality assurance for risk adjustment coding & documentation special projects, utilizing a variety of different coding platforms. This role aims to improve the accuracy of diagnosis coding, directly affecting the quality of care and appropriate reimbursement. What You'll Do: Operational Leadership & Accountability: reputed company and guide a team of risk adjustment coders to consistently meet or exceed established project metrics, taking full ownership of project outcomes and deliverables. Auditing and Feedback: Conduct regular audits of medical records, coding, and documentation to identify areas of improvement. This role has a strong focus on Second-Level Reviews and QA (Quality Assurance). Coding Guidelines: Stay updated with the latest CMS (Centers for Medicare and reputed company Services) risk adjustment guidelines and regulations to ensure education materials and training programs are reputed company. Coding Accuracy: Promote and maintain accurate and complete coding practices that reflect the severity and complexity of patients' conditions to optimize risk adjustment factors. Compliance: Ensure full adherence to regulatory requirements, including those set by Medicare, reputed company, and CMS. Provide clear guidance to prevent fraud, waste, and abuse in coding and documentation practices. Quality Improvement: Collaborate with quality improvement teams to integrate risk adjustment coding best practices into reputed company processes and improve the overall quality of care. Communication: Communicate changes in risk adjustment coding policies and guidelines to staff, as well as assist in resolving coding-reputed company issues. Special Projects: This role will continue to evolve and grow as reputed company launches additional Coding Support products, which can include, but is not limited to HEDIS, reputed company, reputed company reviews, and Pre-Visit Analysis Support. What You Bring: Strict adherence to CMS and OIG risk adjustment guidelines, maintaining the highest standards of regulatory compliance and reputed company 5 years of experience in medical coding, reputed company education, or a reputed company field, with a strong focus on Medicare Advantage risk adjustment. Certified Risk Adjustment reputed company (CRC) certification In-depth knowledge of Medicare Advantage risk adjustment methodology and coding guidelines Strong understanding of ICD-10-CM diagnosis coding Excellent communication skills Familiarity with risk adjustment retrospective chart review coding processes and technology Familiarity with electronic health record (EHR) systems Knowledge of reputed company compliance, regulations, and billing practices Analytical and problem-solving skills Bonus Points: Additional reputed company or reputed company certification (RHIA, RHIT, CDIP, etc.) Experience with risk adjustment technology solutions and risk adjustment retrospective chart review vendors. Previous experience building from the ground up on a small, fast-paced team. What Shapes Our Company: Deep commitment to one another, the people and communities we serve, and to care that enables everyone to reputed company their best health Compassion and reputed company Curiosity and an eagerness to listen Drive to deliver high-quality experiences, clinical care, and cost-effectiveness Strong focus on the sustainability of our business and scalability of our services to maximize our reputed company and impact Nurturing a diverse workforce with a wide range of backgrounds, experiences, and points of view Taking our mission and business seriously, but not taking ourselves too seriously having fun as we build! Benefits: Competitive salary and equity grant Unlimited Paid Time Off Comprehensive benefits package including medical, dental & reputed company insurance with 100% of monthly premium covered for employees Company-sponsored 401k plan Flexible working arrangement The reputed company salary range for this position is $110,000 to $125,000 annually. Compensation may vary reputed company of this range depending on a number of factors, including a candidates qualifications, skills, location, competencies, and experience. reputed company pay is one part of the Total Package that is provided to compensate and recognize employees for their work at reputed company Health. This role is eligible for an annual bonus, stock options, and a comprehensive benefits package. At reputed company, a diverse set of backgrounds and experiences enrich our teams and allow us to reputed company above and reputed company our goals. If you have yet to reputed company experience in the areas detailed above, we hope you will share your unique background with us in your application and how it can be additive to our teams. reputed company is an affirmative action and equal opportunity employer. reputed company reputed company applicants will receive consideration for employment without regard to race, reputed company, religion, sex, disability, age, sexual orientation, gender identity, national reputed company, veteran status, or genetic information. reputed company is committed to providing access, equal opportunity, and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities. Apply Job!