Manager, Coding Quality and Compliance Auditing

Role Description

Oak Street Health®, a part of CVS Health, helps older adults stay healthier and live fuller lives through our 230 centers across 27 states. Our value-based care model helps us consistently deliver better patient experiences and outcomes.

About the role

Manager of Coding Quality and Compliance

Responsibilities

• Technical chart auditing
• Epic work queue rules maintenance
• Deletion log tracking
• External CMS RADV/OIG audit operational preparation
• AHIMA query governance
• Epic Rule Engine Optimization
• Deletion Log Maintenance & Overpayment Tracking
• Payer Data Ingestion Auditing

Requirements

• Post secondary /high school education or specialized training, i.e., technical/vocational programs
• 5 to 7 years relevant experience
• 2 to 4 years of risk adjusted coding experience
• Certified Coding Specialist (CCS), Certified Coding Associate (CCA) or Certified Professional Coder (CPC)
• Credential of at least 3 years by AHIMA or AAPC required. Dual AAPC certification a plus.
• Credential must be current, in good standing, and maintained during employment.
• ID-10 Coding certification
• ID-9-CM coding experience
• ID-10-CM coding experience
• Proven coding competency
• Prior medical chart auditing/quality experience
• Advanced knowledge of medical terminology, abbreviations, anatomy and physiology, major disease processes and pharmacology

Qualifications

• Dual AAPC certification a plus.
• Advanced knowledge of medical terminology, abbreviations, anatomy and physiology, major disease processes and pharmacology

Skills

• Subject matter expert
• Problem solver
• Relationship builder
• Talent for creative problem solving & execution
• Excellent at communicating audit & compliance concepts to colleagues in other functions

Benefits

Mission-focused career impacting change and measurably improving health outcomes for Medicare patients
Paid vacation, sick time, and investment/retirement 401K match options
Health insurance, vision, and dental benefits
Opportunities for leadership development and continuing education stipends
Opportunities for high levels of responsibility and rapid advancement

Pay

The Typical Pay Range For This Role Is $66,330.00 - $145,860.00

Schedule

Full time