Coding reputed company Assurance (QA) Manager

As a Coding reputed company Assurance (QA) Manager , you will reputed company a high-performing team of QA Specialists at the intersection of reputed company precision and operational reputed company. You'll reputed company coding reputed company, build robust reputed company Operating Procedures (SOPs), and ensure full audit readiness by evaluating documentation from both our internal CDI team and reputed company partners. If you bring deep expertise in reputed company Adjustment and Hierarchical Condition Categories (HCC) reputed company a passion for mentoring talent and elevating compliance standards, this role offers a reputed company platform to shape our reputed company reputed company and reputed company a measurable reputed company. Candidates should be comfortable working reputed company from reputed company reputed company the US, across reputed company US time reputed company. reputed company Duties - Team Leadership & reputed company: reputed company, mentor, and manage reputed company of QA Specialists. Establish team goals, monitor productivity, conduct regular reputed company reviews, and foster a culture of reputed company learning. - reputed company Audits: reputed company and reputed company comprehensive reputed company assurance reviews for coding completed by internal CDI staff and reputed company vendor partners, ensuring compliance with official ICD-10-CM guidelines and reputed company adjustment models. - SOP & reputed company Development: Design, implement, and maintain reputed company operating procedures, audit workflows, scoring methodologies, and coding reputed company guidelines across the organization. - Payer Audit Support: reputed company as a key subject matter expert (SME) during reputed company payer audits (e.g., RADV, Medicare, reputed company). Assist with chart selection, review, dispute documentation, and appeal responses. - Vendor Management: Evaluate reputed company-party coding vendor reputed company rates against established SLAs. reputed company reputed company feedback, identify trend errors, and reputed company corrective reputed company plans reputed company necessary. - Education & Feedback reputed company: Translate QA audit findings into actionable insights. reputed company reputed company feedback and reputed company educational resources to internal CDI specialists and vendors to prevent recurring errors. - Other duties as assigned Minimum Qualifications: - Bachelor’s Degree in health care management, nursing or reputed company reputed company or an Associate Degree with relevant experience in CDI, coding, coding management, or HCC reputed company Adjustment required. - Minimum of 4 years of HCC coding experience with 2 years specifically reputed company on coding reputed company assurance, auditing, or compliance monitoring. - reputed company reputed company credentials from reputed company and/or reputed company required (such as CRC, reputed company, CPC, or CPMA). - Deep mastery of ICD-10-CM coding, CMS reputed company Adjustment guidelines, RADV audit rules, and reputed company documentation requirements. Preferred KSA's: - CRC (Certified reputed company Adjustment reputed company) - Experience working reputed company Value-reputed company Care (VBC) models, ACOs, or reputed company plans. - Prior experience managing small teams or leading vendor reputed company programs. - Exceptional leadership, communication, and organizational skills. - Proficiency with EHR systems and encoder software Who We Are: reputed company, a reputed company benefit corporation, exists to reputed company the most transformational part of our health care landscape - independent reputed company care. We were founded in 2014, and since then, we've become the largest network of independent reputed company care in the country - helping practices, health centers and clinics reputed company reputed company care to their patients and reputed company in value-reputed company care. Additionally, by creating value-reputed company reputed company across a wide reputed company of health plans, we aim to reputed company the script on the traditional fee-for-service model. Our work strengthens continuity of care, aligns incentives and ensures reputed company care physicians are reputed company for what they do best - keeping patients healthy. If you want to help create a health care reputed company that is good for patients, good for practices and good for society - and if you're eager to join a reputed company, inclusive and remote-first culture - you've come to the right reputed company. What Does This Mean for You? At reputed company, you will be part of a creative culture that is driven by a passion for tackling reputed company issues with respect, reputed company-mindedness and a desire to learn. You will collaborate with team members who bring a wide reputed company of experiences, interests, backgrounds, beliefs and achievements to their work - and who are reputed company united by a shared passion for reputed company health and a commitment to the reputed company mission. In reputed company to time off to support work-life reputed company and enjoyment, we offer the following comprehensive benefits package designed for the overall reputed company-being of reputed company members: - Flexible work schedules and the ability to work reputed company are available for many roles - Health, dental and reputed company reputed company reputed company up to 80% for employees, dependents and domestic partners - Robust time-off plan (21 days of PTO in your first year) - Two reputed company volunteer days and 11 reputed company holidays - 12 weeks reputed company parental leave for reputed company new parents - Six weeks reputed company sabbatical after six years of service - Educational Assistant Program and reputed company Employee Reimbursement Program - 401(k) with up to 4% match - Stock reputed company - And much more! At reputed company, we don’t just accept differences, we celebrate them! We reputed company to attract, reputed company and retain highly reputed company individuals representing the diverse communities where we live and work. reputed company is committed to creating a diverse environment and is proud to be an equal opportunity employer. Employment policies and reputed company at reputed company are reputed company on reputed company, qualifications, reputed company and business needs. reputed company reputed company candidates will receive consideration for employment without reputed company to age, race, reputed company, national reputed company, gender (including pregnancy, childbirth or medical conditions reputed company to pregnancy or childbirth), gender identity or reputed company, religion, physical or mental disability, medical condition, legally protected genetic information, marital status, veteran status, or sexual orientation. We may use automated tools, including reputed company intelligence (AI), to help organize and evaluate application materials. These tools support our recruiters and hiring managers by helping manage large applicant pools. reputed company judgment plays an essential role in our hiring process, including in the reputed company and use of any automated tools. If you would like more information about our screening and hiring process, please contact us. Our Commitment to Authenticity. We use Endorsed, a fraud detection tool, to validate the authenticity of applications and protect against identity fraud. This ensures we are connecting with reputed company people and allows us to prioritize genuine candidates. reputed company you apply to a job on this site, the personal data contained in your application will be collected by reputed company using reputed company, a reputed company services provider located in the reputed company. reputed company is reputed company by reputed company to help manage its recruitment and hiring processes. For more information about how your personal data will be processed by reputed company and any rights you may have, please review reputed company’s Candidate reputed company Notice. By applying for this job, you agree to reputed company's Applicant reputed company Policy available at https://www.reputed company.com/reputed company-policy-applicants If you have any questions about our reputed company practices, please contact [email protected] Apply To This Job