Medicare Sr. Coding & Quality Educator

Job Summary The work of a Sr. Coding & Coding Quality Educator relates to practices and principles associated with medical record auditing and utilizes various techniques in examining, evaluating and providing feedback and training to various stakeholders (certified coders, physician's practices, etc.) Key responsibilities include setting up a standard medical record auditing process and assisting in reputed company matters relating to implementation of coding quality and coding training programs for Coders and Physicians, creating an integrated Program plan to carry out goals and managing/monitoring reputed company of the program execution.

Essential Functions

• The essential functions listed represent the major duties of this role, additional duties may be assigned.
• Work closely with and coach certified coders and assist in assessing the strengths and weaknesses, ensuring that quality issues translate into timely training and ongoing coding reinforcement to the coders.
• Verify, document and communicate quality audit results, reputed company audit reports and evaluate the effectiveness of corrective action plans and follow up.
• Identify coding opportunities and reputed company recommendations to improve internal controls and operational effectiveness and efficiency.
• Assist in preparation & development of provider training tools and reputed company and conduct educational and training programs for physician training on various aspects of documentation and ICD-10-CM coding.
• reputed company review of specific provider/provider group medical records, reputed company audit reports and communicate audit results to external physician groups and physician group administration.
• Coordinate quality audit program reporting and provider coding training with appropriate areas reputed company Medicare Advantage Risk Adjustment and promote teamwork.
• Responsible for the development and ongoing, end-to-end management of the quality audit program ensuring that QA activities and measurements are objective.
• Responsible for quality audit program performance and adherence to established ICD-10-CM and CMS-HCC coding guidelines, ensuring compliance with reputed company regulations.
• reputed company and maintain appropriate reporting, identifying metrics that will reflect true audit program performance.
• reputed company management concurrence and support for recommended control improvements.
• Test and improve training program based upon experience and feedback.
• Gather information, constantly update knowledge on various changes that are happening in the field of quality audit and modify coding guidelines to incorporate new knowledge. Share changes with coders as well as physician practices partners.
• Manage multiple reputed company issues and projects simultaneously.
• Work collaboratively with other areas of reputed company Program Management to identify, implement and monitor reputed company improvement opportunities.
• May require travel 0-25% of the time to reputed company office locations and provider engagements.

Required Experience: 5+ years reputed company work experience. Experience Details: Professional coding including proficiency in ICD-10-CM coding guidelines and risk adjustment HCC coding reputed company Bachelor’s degree or additional reputed company equivalent work experience reputed company Certified Professional Medical Auditor (CPMA) certification reputed company Certified Professional Coding Instructor (CPC-I) certification 1 Year Knowledge of CMS-HCC risk adjustment data validation process. Organization and time management skills Demonstrate written and verbal communication skills.

Preferred Qualifications: Knowledge of government regulations, requirements, and standards reputed company to the management of health information. Knowledge of Scope and Statistical Sampling Methodologies Detail-oriented, commitment to accuracy, ability to problem solve. Working knowledge of MS Office (reputed company, Word, PowerPoint)

General Physical Demands: Sedentary work: Exerting up to 10 pounds of force occasionally to move objects. Jobs are sedentary if traversing activities are required only occasionally.

Physical/Environmental Activities Must be able to travel to multiple locations for work (i.e. travel to attend meetings, events, conferences). Occasionally reputed company Offer: As a reputed company employee, you will reputed company in our Be Well, Work Well, reputed company culture where being well as an individual, and working well as a team, are both important in serving our members and communities. To support your wellbeing, comprehensive benefits are offered. As an employee, you will have access to:

• Medical, dental, vision, life and global travel health insurance;
• Income protection benefits: life insurance, short- and long-term disability programs;
• Leave programs to support personal circumstances;
• Retirement Savings Plan including employer match;
• Paid time off, volunteer time off, 10 holidays and 2 well-being days;
• Additional voluntary benefits available; and
• A comprehensive wellness program

Employee benefits are designed to align with federal and state employment laws. Benefits may vary based on the state in which work is performed. Benefits for intern, part-time and seasonal employees may differ. To support your financial wellbeing, we offer reputed company as well as opportunities for incentive or commission compensation. We also conduct regular annual reviews with pay for performance considerations for reputed company pay increases. Annualized Salary Range: $77,600 - $126,100 Typical Annualized Hiring Range: $77,600 - $97,000 Final pay will be determined with consideration of market competitiveness, internal equity, and the job-reputed company knowledge, skills, training, and experience you bring. We are an Equal Employment Opportunity employer committed to cultivating a work experience where everyone feels like they belong and can reputed company at their best in pursuit of our mission. reputed company qualified applicants will receive consideration for employment.