Manager, Coding Quality Review (Remote)

About the role

Provides leadership for either professional fee and facility-based ambulatory coding auditors/educators within Adventist Health. Leads the implementation and facilitation of ongoing coding audits, reporting, and coding education for ambulatory coding teams, vendor coding teams, and other external/internal stakeholders as needed. Manages projects and initiatives related to ensuring coding integrity and maintaining the highest degree of coding accuracy, documentation integrity, charge capture accuracy and regulatory compliance across ambulatory settings. Supervises and directs the activities of various levels of assigned personnel utilizing both professional and supervisory discretion and independent judgment.

Responsibilities

• Manages the CQR audit/education team to ensure all regularly scheduled and ad hoc quality reviews are completed, in addition to all other team’s daily responsibilities.
• Ensures all coding education needs are being addressed by coordinating education initiatives to internal and external teams, as well as providing oversight for coding education library and resource materials.
• Oversees the audit appeal process to ensure the integrity and accuracy of all coding reviews.
• Manages respective team to ensure assigned Key Performance Indicators are met.
• Ensures all CQR team members maintain up-to-date knowledge of medical terminology, coding guidelines, quality standards, regulatory changes, etc. that affect the audit process.
• Develops, recommends, and oversees the implementation and administration of policies and procedures of respective area.
• Evaluates process and procedures and coordinates with the leadership team to ensure efficient areas of focus and adhere to federal and local laws and regulations.
• Demonstrates, through plans and actions, a consistent standard of excellence to which all department work is expected to conform.
• Works with cross-functional team members to identify and solve process issues.
• Focuses on continuous improvement working with the leaders across the health system with a goal of delivering the highest degree of quality service possible.
• Conducts recurring quality assurance audits and provides coaching sessions/performance reviews in relation to set benchmarks.
• Completes, reviews, manages and monitors department budget.
• Performs other job-related duties as assigned.

Requirements

• Education and Work Experience: Bachelor's degree or equivalent combination of education/experience: Required Master's degree: Preferred Five years' of hospital-based coding or Five years of professional fee coding experience: Required Two years' leadership experience: Required Three years of previous coding audit experience: Preferred
• Licenses/Certifications: Certified Coding Specialist credential through AHIMA (CCS) or Certified Professional Coder (CPC) through AAPC, CPMA certification preferred: Required Current permanent U.S. work authorization: Required

Qualifications

Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.

Skills

• Strong leadership skills
• Excellent communication and interpersonal skills
• Ability to manage multiple tasks and priorities
• Proficiency in medical terminology and coding guidelines
• Experience with regulatory compliance and auditing processes
• Strong organizational and project management skills
• Ability to analyze data and make informed decisions
• Knowledge of healthcare industry standards and best practices

Benefits

Comprehensive benefits package available for qualifying positions, including medical, dental, vision, retirement plans, paid time off, and more.

Pay

The estimated base pay for this position is $114,359 to $171,538. Additional individual compensation may be available for this role through differentials, extra shift incentives, bonuses, etc.

Schedule

Day Shift