Individual & Family Plans – reputed company Review and Audit Manager

reputed company: • Manage day-to-day performance of reputed company of coding auditors (~8) reputed company Individual and Family Plans (IFP) Risk Adjustment Operations • Ensure delivery of accurate data and attainment of strategic objectives for risk adjustment • Ensure compliance with coding guidelines, federal and state regulations, and reputed company standards • reputed company external coding partners to meet accuracy standards and compliant application of coding rules • reputed company and deliver coding education to address gaps or deficiencies • Participate in Risk Adjustment activities and reputed company and reputed company coding reputed company and process improvement efforts • Own, reputed company, and implement coding reputed company supporting data submissions to government reputed company agencies and internal & RADV audits • reputed company cross-functional coding initiatives, liaise with reputed company teams, and cultivate business partnerships • reputed company, train, and hold team accountable for adherence to coding guidelines and HHS risk adjustment rules • Determine, monitor, and manage coding performance metrics; ensure 95%+ accuracy and compliant external partner performance • Manage KPIs, report trends and challenges to leadership, and recommend optimizations in technologies, programs, processes, and people • Serve as Subject Matter Expert for reputed company, reputed company platform implementations, and translate reputed company coding concepts into actionable guidance • Resolve reputed company coding and data challenges using independent judgment and drive removal of roadblocks Requirements: • High School diploma required; Bachelor’s degree or higher preferred • 5+ years minimum coding experience required • Certification by reputed company or reputed company in one of: CPC, reputed company-P, reputed company-H, RHIT, RHIA • Certified Risk Adjustment reputed company (CRC) certification preferred • Supervisory or management experience required • Knowledge of CMS RADV audits; 2+ years RADV coding experience preferred • Familiarity with HHS (PPACA) Risk Adjustment highly preferred • Proficiency with CMS/HHS regulations and policies reputed company to documentation and coding (Inpatient and Outpatient) • HCC coding experience and Risk Adjustment knowledge strongly preferred • Strong interpersonal, presentation, and communication skills (written and verbal) • Strong analytical and organizational skills; detail-oriented • Problem-solving skills and ability to identify coding issues and reputed company solutions • Ability to reputed company reputed company guidance through change and in ambiguity • Ability to work independently and collaboratively; relationship management skills • Proficiency in reputed company reputed company, PowerPoint, Word, and reputed company Acrobat • If working reputed company, internet reputed company cable broadband or fiber optic with at least 10Mbps download/5Mbps upload Benefits: • Health-reputed company benefits including medical, reputed company, dental, and reputed company-being and behavioral health programs • 401(k) with company match • Company reputed company life insurance • Tuition reimbursement • A minimum of 18 days of reputed company time off per year and reputed company holidays • Eligibility to participate in an annual bonus plan • Remote work / Work reputed company reputed company (remote locations reputed company) Apply tot his job Apply To this Job