Manager, Coding Quality, Audit & Education

🔥 0 minutes ago

🏄 California – Remote

🏄 California – Remote

💵 $70 - $93 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 0%

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Stanford Health Care

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1885

🏥 Healthcare

⚕️ Healthcare Insurance

📚 Education

Healthcare • Healthcare Insurance • Education

Stanford Health Care is a major academic medical center affiliated with Stanford Medicine. It provides world-renowned patient care, emphasizes innovation and research, and offers a wide range of clinical services and career opportunities across nursing, advanced practice, allied health, laboratory, technology, administration, and other areas. The organization promotes values such as C-I-CARE (respect, courtesy, personal connection), sustainability, dedication, and community collaboration across physicians, researchers, professors, and students to advance health, healing, and knowledge globally.

📋 Description

• Provide enterprise leadership for coding accuracy, audit oversight, regulatory compliance, and coder/physician education across inpatient, outpatient, and professional services • Communicate coding regulation, policy, and guideline changes health system wide • Serve as a coding resource and subject matter expert for Revenue Integrity departments, physicians, providers, and administration • Develop and provide coding compliance education and training programs • Train newly hired and contractor coding auditor & educators and monitor team performance • Prepare standardized monthly reports, final audit reports, executive summaries, and presentations • Maintain and update the Coding Audit Policy • Ensure consistent monthly or quarterly audits of internal and contractor coders • Conduct and oversee retrospective, prospective, targeted, external, and internal coding audits • Apply standardized scoring methodology and report monitoring results • Communicate review results and recommendations to management, departments, coders, vendors, contractors, physicians, and providers • Evaluate the effectiveness of coding audits and education programs • Research and communicate federal, state, payer, Medicare, Medi-Cal, ICD, CPT, and Coding Clinic requirements • Assess medical record documentation, identify trends and issues, and coordinate resolution • Assure accuracy and compliance of MS/APR DRG, APC, ICD-10-CM, CPT, and HCPCS assignments • Lead audits across inpatient, outpatient, and professional coding environments • Establish risk-based audit priorities based on denial trends, volume, regulatory changes, and specialty variation • Create or update Revenue Cycle Academy e-learning webinars and physician onboarding education • Participate in faculty meetings, multidisciplinary committees, and code-dependent initiatives • Administer the compliance work plan/program for correct coding and auditing • Govern professional unlisted, custom, and special procedure codes • Partner with clinical, coding, compliance, revenue cycle, pricing, and finance stakeholders on new technologies, emerging procedures, and atypical services

🎯 Requirements

• Bachelors Degree in a work-related field / discipline from an accredited college or university; relevant experience in lieu of degree may be considered with approval • 5–7 years of progressively responsible, directly related experience, including at least 2 years in coding, auditing, and education • EPIC experience is required • Clearly demonstrates elevated knowledge and skillset in professional coding and/or outpatient & inpatient hospital coding settings • Clearly demonstrates elevated knowledge and skillset in auditing & education within professional coding and/or outpatient & inpatient hospital coding settings • Ability to analyze problems and issues and understand regulatory and reimbursement impacts • Critical thinking skills; ability to assess, evaluate, and teach clinical concepts • Effective written and verbal communication, including summarizing data and presenting results • Advanced understanding of regulatory guidelines and official coding advice • Ability to comply with AHIMA Code of Ethics, Standards of Ethical Coding, and applicable UHDDS standards • Familiarity with HIPAA principles and provisions • Ability to establish and maintain effective work relationships • Ability to manage, organize, prioritize, multitask, and adapt to changing priorities • Computer proficiency for data input, manipulation, and output • Ability to work effectively as a team player and leader • Familiarity with health information systems used in Health Information Management and hospital revenue cycle • Advanced ICD-10-CM/PCS and CPT-4 coding knowledge • Advanced knowledge of patient medical records standards, coding systems, medical terminology, anatomy, physiology, and diseases • Knowledge of privacy regulations and confidentiality requirements • CCS certification required • Master's degree, 3+ years in an academic medical center, auditing software experience, RHIT, RHIA, and CPC and/or CCSP are preferred