Manager – Coding Quality, Audit & Education

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🔥 0 minutes ago

🇺🇸 United States – 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

Stanford Health Care is a major academic medical center and integrated hospital system delivering comprehensive clinical care, specialty services, and patient support. The organization operates hospitals, outpatient clinics and programs, offers clinical trials and telehealth (video visits), and provides patient-facing services such as a MyHealth patient portal, billing/insurance assistance, and resources for referring physicians, nurses and allied health professionals. It also engages with the community through donations, visitor services, and COVID-19 resources.

📋 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, physicians, administration, and Stanford Healthcare • Develop and provide coding compliance education and training programs • Train newly hired and contractor coding auditor and educators • Monitor the Coding Audit & Education team and report standardized monthly results • Maintain and update the Coding Audit Policy • Ensure monthly or quarterly audits of internal and contractor coders • Conduct and oversee retrospective, prospective, targeted, external, and internal coding audits • Apply standardized scoring methodologies and report monitoring results • Prepare audit reports, executive summaries, recommendations, and management presentations • Communicate audit findings to coding management, physicians, providers, vendors, contractors, and departments • Evaluate coding audits and education for regulatory and compliance effectiveness • Research and communicate federal, state, payer, Medicare, Medi-Cal, ICD, CPT, and Coding Clinic rules and updates • Assess medical record documentation and identify trends and issues for resolution • Assure accuracy and compliance of coding, MS and APR DRG, APC, ICD-10-CM, CPT, and HCPCS assignments • Lead audits across inpatient, outpatient, and professional coding environments • Establish risk-based audit priorities • 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 and manage professional unlisted, custom, and special procedure codes • Partner with clinical, coding, compliance, revenue cycle, pricing, and finance departments on new technologies, 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 and is in addition to the experience requirements • Masters Degree in a work-related field/discipline preferred • 5–7 years of progressively responsible, directly related experience, including at least 2 years in coding, auditing, and education • EPIC experience is required • 3 or more years in an academic medical center preferred • Experience with auditing software preferred • Elevated knowledge and skillset in professional coding and/or outpatient and inpatient hospital coding settings • Elevated knowledge and skillset in auditing and education within coding settings • Ability to analyze problems and understand regulatory and reimbursement impacts • Critical thinking skills and 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 UHDDS standards • Knowledge and understanding of HIPAA • Advanced knowledge of ICD-10-CM/PCS and CPT-4 coding conventions • Knowledge of medical records, coding systems, medical terminology, anatomy and physiology, and diseases • Knowledge of privacy regulations and confidentiality • CCS (Certified Coding Specialist) required • RHIT, RHIA, CPC and/or CCSP preferred