Manager, Coding Audits and Compliance

Oversees the coding audit and compliance aspects of risk adjustment processes. In partnership with key stakeholders, the role supports the management of oversight of offshore vendors and continuously works to improve people, processes, and technology across the function. The Risk Coding Audit team works to manage accurate and compliant coding practices, find opportunities for documentation improvement, optimize risk adjustment processes, and support revenue cycle management. The position applies knowledge of key business drivers and the factors that improve the Risk Adjustment departmental performance and anticipates business and regulatory issues and trends to identify improvements.

Essential Functions

• Oversee daily risk coding audit operations to ensure compliance with regulations and standards.
• Provide leadership and guidance to the coding audit team, ensuring proper training and adherence to coding guidelines.
• Establish KPIs for...

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