R1 RCM · 2 days ago

Manager of HCC Coding and Audit

United States

Full-time

Remote

Mid, Senior Level

$72K/yr - $109K/yr

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Responsibilities

You will be working with several different Electronic Health Records and host billing systems and encoders as applicable to the various R1 clients.

You will help build a dedicated team of HCC coding professionals focusing on ICD-10-CM.

Manage coding audits, including internal QR monitoring reviews. Responsibility for planning, monitoring, following up, and escalating any concerns to ensure the coding audits within the audit work plan stay on track and are completed in within a timely manner.

Maintain audit documentation, including audit cycle steps, client policies and procedures and training materials.

Work closely with the Director of Coding to ensure timely delivery of necessary education based on audit results; and assist in the development discussions for Corrective Action Plans (CAPs) based on audit findings.

Create audit reports, and follow up emails with the assistance of templates and audit resources, and distribute following review and approval by leadership.

Communicate coding audit findings to auditors, leaders, and clients, including applicable references, as appropriate.

Manage the global coding team as well as domestic QA reviewers, including direct people leader tasks such as timecard review/approval, PTO review/approval, work assignments, productivity monitoring, employee engagement, and general staff oversight, including keeping team informed about expectations, performance, and organizational and/or process changes.

Serve as a coding subject matter expert.

Provide guidance on documentation requirements, coding queries, and recommend process improvements.

Keep current on coding changes, specifically as they relate to HCC and ICD-10-CM coding and billing guidelines.

Research and resolve coding and/or documentation inquiries using authoritative sources.

Assist in performing routine coding compliance audits as needed on domestic QA reviewers.

Collaborate with a broad spectrum of service lines and professionals, ranging from senior management to front line site and service leaders to clients and vendors.

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

CCSCCS-PCPCHCC coding guidelinesICD-10-CMCRCFederal healthcare regulationsEMR systemsLeadership experienceStakeholder engagement

Required

Active coding credential: CCS, CCS-P, or CPC required. CPC-A is not applicable.

Strong knowledge of CMS HCC coding guidelines and regulations.

Previous leadership or management experience including communication and interpersonal skills as this is a client facing position.

Knowledge of federal health care program statutes, regulations, rules and guidance regarding reimbursement, condition of payments and other material requirements.

Experience working with multiple EMRs, systems, clients, and contracts.

Successful relationship building and credibility with key stakeholders and subject matter experts in relevant service lines.