Coding Manager, Risk Adjustment

🔥 4 minutes ago

🇺🇸 United States – Remote

💵 $82k - $102k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🎲 Risk

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Cotiviti

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

⚕️ Healthcare Insurance

💳 Fintech

🤖 Artificial Intelligence

Healthcare Insurance • Fintech • Artificial Intelligence

Cotiviti is a healthcare technology and analytics company that specializes in improving payment accuracy and performance through advanced data analytics solutions. They partner with health plans, government agencies, and healthcare providers to deliver insights that enhance quality and efficiency in care delivery. With solutions such as risk adjustment, payment policy management, and member engagement, Cotiviti aims to optimize financial and clinical outcomes for the healthcare ecosystem.

📋 Description

• The Coding Manager leads a team of coders, directly or indirectly, to deliver key components to the Cotiviti coding program. • Work with the Director of Coding, the Client team and other areas related to production, QA, and analytics for oversight of ongoing production and quality accuracy. • Facilitates all production meetings with Reporting, Data Capacity operations planning, and leadership to develop coding and abstraction production plans. • Communicates production plans, quality goals and project priorities to internal Coding teams as well as external vendor partners in preparation for on-boarding and/or scheduling of all client projects, including on and offshore coding. • Resolve issues that impact coding production and the full utilization of coding abstraction services for MRA, CRA and Medicaid. • Utilize Coding forecast and coding output data to monitor coding productivity and quality; address coders work performance concerns through meeting with the Coder and/or coding vendor leadership to develop an action plan as needed regarding production and quality accuracy standards. • Constructs and communicates internal system reports for all coders (Coder I, Coder II, QA I and QA II and Team Leads) in the Clinical Coding Department. • Ensures completion of various chart types (physician, hospital outpatient, hospital inpatient) from both a production and quality accuracy perspective. • Frequently meets with clients to provide meaningful updates on project progress; works closely with client success and coding quality to ensure successful deliverables. • Hire, develop, coach, lead and retain top-tier talent, with a focus on building and improving a team and culture that is able to assist in employing best in class practices to support and drive high levels of internal and external customer satisfaction.

🎯 Requirements

• Bachelor’s degree, Coding certification; RHIA, RHIT, CRC, CCS, CCS-P, CPC, CPC-H (Nationally certified medical coder as certified by either AAPC or AHIMA) or 4 years equivalent work experience. • 5+ years of HCC medical coding, record abstraction experience, including supervisory experience. • Ability to establish, monitor and enforce staffing schedules and production schedules. • Ability to analyze data to identify trends, outliers or areas that need attention from both a production and quality perspective, and implement changes as needed. • Ability to act as a coding resource or QA resource for Medicare Risk Adjustment, Commercial Risk Adjustment and Medicaid when production volume is required. • Excellent written and verbal skills including coaching and interpersonal skills, and client interaction. • Strong knowledge of medical terminology and anatomy and physiology. • Analytical and critical thinking skills to understand data to influence decision making. • Computer and technology literate. • Manage multiple client deliverables and competing deadlines simultaneously. • Awareness and adherence to HIPAA privacy and security regulations.

🏖️ Benefits

• Medical, dental, vision, disability, and life insurance coverage • 401(k) savings plans • Paid family leave • 9 paid holidays per year • 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti