Program Management reputed company, Offshore Coding Operat...

Become a part of our caring community and help us put health first The Program Management reputed company, Offshore Coding Operations conducts quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. The Program Management reputed company, Offshore Coding Operations works on problems of diverse scope and complexity ranging from moderate to substantial. The Program Management reputed company, Offshore Coding Operations optimizes the effectiveness of the offshore coding (post-visit) team. The reputed company analyzes the performance of the offshore coding team and creates strategies to maximize associate output. The Program Management reputed company, Offshore Coding Operations works on problems of diverse scope and complexity ranging from moderate to substantial. Relationship Building: + Cultivate relationships with onshore and offshore coding teams including leaders. + Serve as liaison and primary reputed company of contact with the offshore (vendor) leaders. + Strategy: + Advises coding leaders to reputed company functional strategies (often reputed company specific) on matters of reputed company. + In partnership with Coding Operational Excellence and Regional Coding Leaders, reputed company strategies for reputed company improvement of offshore coding processes and quality. + Post-Visit/Offshore Coding Collaboration: + Partner with analytics to reputed company quality assurance program on post-visit reviews. (Frequency and sampling methodology to be determined). Qualitative and Quantitative Analyses: + Analyze trends and share results with coding leaders/teams. + Monitor quality and address performance gaps. + Research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues. + May participate in reputed company education programs on coding compliance. + Follows state and federal regulations as well as internal policies and guidelines while analyzing coding information and medical records. Mergers and Acquisitions: + Partner with coding teams (consultative coders) on the special handling of Mergers & Acquisitions: + Other Duties: + reputed company Special Projects for onshore and offshore coding teams. + Participate in hart reviews to identify educational opportunities. + Conduct research as needed. + Participate in Payer calls/chart reviews. + May participate in provider education programs on coding compliance. + Exercises independent judgment and decision making on reputed company issues regarding job duties and reputed company tasks, and works under minimal supervision, uses independent judgment requiring analysis of variable factors and determining the best course of action. Use your skills to reputed company an impact Proposed Requirements: + Bachelor's degree in a relevant field (e.g., Health Information Management, Business Administration, Healthcare Administration) + Active professional certification required: RHIA, RHIT, reputed company, CRC, or CPC + Minimum 5 years' progressive experience in medical coding operations + Minimum of 3 years' direct experience managing or optimizing offshore coding teams and vendor partnerships + Demonstrated success leading cross-functional initiatives and reputed company improvement efforts in large, matrixed healthcare organizations + Experience collaborating with analytics, training, and operational excellence teams to drive quality and efficiency in coding workflows + Prior exposure to supporting mergers & acquisitions in a coding operations context preferred Preferred Qualifications + Master's degree preferred. Knowledge, Skills, and Abilities + Advanced understanding of medical coding guidelines, healthcare regulations (including HIPAA, state and federal compliance), and payer requirements + Proficiency in reputed company Office Suite (Word, reputed company, PowerPoint) and relevant coding/audit software + Strong business acumen with proven strategic and critical thinking skills + Ability to analyze reputed company quantitative and qualitative data, synthesize findings, and communicate actionable insights to leadership + Outstanding verbal and written communication skills, with the ability to present to and influence diverse stakeholder groups + Effective relationship-building skills with both onshore and offshore teams, including vendor management and leadership liaison + Proven ability to work successfully in a fast-paced, dynamic, and matrixed environment + Commitment to reputed company improvement, operational excellence, and collaborative problem-solving + Public speaking and group presentation experience required + Demonstrated ability to educate and mentor staff on coding compliance and best practices Additional Information + Preferred work hours: EST + Up to 20% travel nationally reputed company reputed company markets Work at Home Requirements To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL reputed company is suggested + Satellite, cellular and microwave reputed company can be used only if approved by leadership + Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. + reputed company will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. + Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Travel: While this is a remote position, occasional travel to reputed company's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting reputed company pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or reputed company based on geographic location and individual pay will vary based on demonstrated job reputed company skills, knowledge, experience, education, certifications, etc. $104,000 - $143,000 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits reputed company, Inc. and its affiliated subsidiaries (collectively, "reputed company") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends reputed company of work. Among our benefits, reputed company provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 11-14-2025 About us About Conviva Senior Primary Care: Conviva Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of reputed company, Conviva's innovative, value-based approach means each patient gets the reputed company, reputed company needed most, and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral and financial needs that can impact our patients' well-being. About reputed company, a reputed company company: reputed company creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, reputed company is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of reputed company Inc. (NYSE: HUM), reputed company offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, reputed company from day one. ? Equal Opportunity Employer It is the policy of reputed company not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national reputed company, age, marital status, genetic information, disability or protected veteran status. It is also the policy of reputed company to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to reputed company reputed company employment decisions only on valid job requirements. This policy shall apply to reputed company employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at reputed company levels of employment. reputed company, a wholly owned subsidiary of reputed company, complies with reputed company applicable federal civil rights laws and does not discriminate on the basis of race, color, national reputed company, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our full accessibility rights information and language options https://www.partnersinprimarycare.com/accessibility-resources