Manager, Coding Compliance Auditor

Coding Compliance Audit Manager

As the Coding Compliance Audit Manager, you will drive the design and development of the Strive Health Coding Compliance Program, in addition to managing the Program’s day-to-day operations.  The position reports to the Chief Compliance Officer and engages internally with the Strive Health Revenue Cycle Management, Clinical Informatics, Legal and Technology teams, and externally with 3rd party business partners.  If selected for this role, you will have the opportunity to lead Strive Health's efforts to remain in compliance with billing and coding laws and regulations, and help Strive Health achieve its Mission.

Essential Functions

• Develop, implement and lead the internal fee-for-service and risk adjustment compliance program
• Complete regular coding/billing auditing and monitoring across all Strive Health business lines
• Perform compliance assessments of risk adjustment, billing, and coding policies, procedures, communications, trainings, etc.
• Provide coding-related guidance
• Receive and investigate complaints or concerns regarding Strive health coding, billing, or risk adjustment activities
• Monitor changes to relevant laws and regulations
• Work with the Strive clinical informatics and revenue cycle management teams

Minimum Qualifications

• 3+ years experience with healthcare FFS and risk adjustment billing and coding
• 3+ years experience conducting internal medical documentation and coding audits
• Hold a Registered Health Information Technician (RHIT) and/or Certified Risk Adjustment Coder (CRC) certification (or equivilant)
• 5+ years of provider healthcare experience
• 3+ years experience with federal healthcare program laws including the False Claims Act
• Business travel
• Internet Connectivity - Min Speeds: 3.8Mbps/3.0Mbps (up/down): Latency <60 ms

Preferred Qualifications

• A bachelor's degree or higher in a related field
• Demonstrates empathy, passion for building relationships
• Proven track record of adding value to an organization
• Embodies Strive's core values: Care for Others First, Resilience, Tenacity, Innovation, and Fun
• Attention to detail
• Critical thinking skills
• Computer proficiency, particularly in Microsoft Office Suite
• Independently motivated
• Comfortable working through unknowns and "grey areas" with minimal oversight

Annual Salary Range: $95,000.00 – $117,000.00