Coding and Audit Manager

The Opportunity

 Reporting to the Senior Revenue Cycle Manager, the Coding and Audit Manager is responsible for overseeing and managing the medical coding audit process and the re-code process. Additionally, they will be the primary point of contact for coding of new services which includes working to ensure that all medical coding is accurate and compliant with regulations and industry standards. The Coding and Audit Manager will also be responsible for developing and implementing a medical coding audit plan, analyzing and reporting on coding data, and communicating findings to management and other stakeholders. Lastly, this person will manage a growing team of certified coders.

 The ideal candidate enjoys tackling new challenges and taking on complex problems, and are able to work equally well autonomously or in partnership. Acting with a clear sense of ownership, you take personal responsibility for decisions, actions, and failures. If you are intellectually curious, enjoy a collaborative, team-based environment and are excited about the opportunity to be a part of a high-growth public organization while managing a growing team, we would love to hear from you!

 What you'll likely work on:

• Develop and implement a comprehensive medical coding audit plan to ensure compliance with regulations and industry standards; this will include working with and managing external vendor relationships.

• Organizing and participating in group and 1:1 meetings with Providers to provide coding education, guidance, mentorship, training and to go over their audit results

• Provide coding advice on new programs/services, work with Product to get codes and procedures entered correctly into the EHR and then help ensure correct codes are being used once program launches

• Oversee “re-code” request process 

• Review and analyze medical coding data to identify patterns of errors or non-compliance, as well as areas for process improvement

• Communicate findings and recommendations to management and other stakeholders, including recommended changes to policies, procedures, and training programs

• Collaborate with other departments, including billing, compliance, and revenue cycle, to resolve coding issues and implement process improvements

• Stay current on industry developments and changes in regulations related to medical coding, and update audit plan and training programs as needed

• Prepare regular reports to management and other stakeholders on the status of the audit process, including any identified issues or areas for improvement.

What you’ll need:

• Minimum of 3 years of experience in complex medical coding, audit and compliance and 1+ years recently managing a team in the healthcare space

• CPMA (Certified Professional Medical Auditor) or similar certification required 

• CPC (Certified Professional Coder) or CRC (Certified Risk Adjustment Coder) or similar certification preferred (in addition to CPMA), preferred

• Strong knowledge of medical coding regulations and industry standards, including ICD-10-CM, CPT and HCPCS codes

• Strong analytical and problem-solving skills

• Excellent verbal and written communication skills, ability to communicate complex information to a non-technical audience

• Experience working with electronic health records (EHRs) and other healthcare systems

• Strong project management skills and ability to manage multiple priorities simultaneously

One Medical is committed to fair and equitable compensation practices.

The base salary range for this role is $76,000 to $106,000.  However, actual compensation packages are based on several factors that are unique to each candidate. These factors include, but are not limited to, job related knowledge and skill set, depth of experience, certifications and/or degrees, and specific work location. 

The total compensation package for certain roles may also include additional components such as a sign-on bonus, annual performance bonus, equity grants in the form of RSUs, medical and other benefits and/or other applicable incentive compensation plans. For more information, please visit https://www.onemedical.com/careers/.

Benefits designed to aid your health and wellness:

Taking care of you today

• Paid sabbatical after 5 and 10 years
• Employee Assistance Program - Free confidential advice for team members who need help with stress, anxiety, financial planning, and legal issues
• Competitive Medical, Dental and Vision plans
• Free One Medical memberships for yourself, your friends and family
• Pre-Tax commuter benefits
• PTO cash outs - Option to cash out up to 40 accrued hours per year

Protecting your future for you and your family

• 401K match
• Opportunity to participate in company equity programs
• Credit towards emergency childcare
• Company paid maternity and paternity leave
• Paid Life Insurance - One Medical pays 100% of the cost of Basic Life Insurance
• Disability insurance - One Medical pays 100% of the cost of Short Term and Long Term Disability Insurance

This is a full-time remote role based anywhere in the United States.

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