We are seeking a Senior Manager to lead our auditing team, providing quality control functions to ensure operational objectives and quality metrics are met or exceeded. This role involves leading and managing the DRG, Professional, and Outpatient audit team, coordinating onboarding and training, completing audits and quality reviews for compliance with coding guidelines and client requirements, and conducting provider dispute audits.
Additional responsibilities include reporting audit team performance, hiring and training auditors including interviews and ongoing education, interacting with internal teams and clients to meet expectations, and maintaining superior knowledge of coding guidelines, reimbursement trends, and healthcare payment policy language.
The position offers a fully remote work environment with about 10% travel and includes comprehensive benefits such as medical, dental, vision, life, and disability insurance, Employee Assistance Program, 401K with company match, flexible spending and health savings accounts, flexible time off, paid parental leave, and pet insurance.
- Bachelor's degree
- 10+ years of inpatient coding, auditing, and quality review experience in payment integrity
- 3 years of supervisory/management experience including managing/training in a remote work setup
- Certified Coding Specialist (CCS) credential
- Expert knowledge of ICD-10-CM/PCS coding, MSDRG, APRDRG, and US healthcare payment methodologies for Commercial, Marketplace, Medicare, and Medicaid
- Excellent English communication, strong analytical skills, and attention to detail
- Experience with CMS NCDs/LCDs and clinical criteria guidelines
Nice to have:
- Experience in startup or high-growth company environments
- Familiarity working with diverse, global teams
- Proficiency with Mac computers
- CPC certification in addition to CCS
- Fully remote role with limited travel
- Medical, dental, vision, life, disability insurance
- Employee Assistance Program
- 401K plan with company match
- Flexible spending and health savings accounts
- Flexible time off and company holidays
- Up to 14 weeks paid parental leave
- Pet insurance
Location
N/A
Employment Type
Full-time
Experience Level
Manager
Salary Range
$125,000 - $140,000
Remote work allowed
Yes
Posted
1 week ago