Senior Risk Adjustment Audit Director
4 weeks ago
CenterWell Primary Care is seeking a highly skilled and experienced Senior Risk Adjustment Audit Director to join our team. As a key member of our leadership team, you will be responsible for overseeing quality assurance audits of medical records, ICD-10-CM, CPT, and HCPCS codes submitted to CMS, other payers, and government agencies. You will also be responsible for leading a team of coding and documentation auditors who ensure coding is accurate and properly supported by clinical documentation within the health record.
Responsibilities:
Lead a team of coding and documentation auditors who ensure coding is accurate and properly supported by clinical documentation within the health record.
Develop and implement strategies for improving clinical documentation and coding for pre and post-visit coding.
Prepare quarterly audit reports outlining quarter-by-quarter comparisons, trend identification, action plans, and other pertinent information.
Collaborate with clinical and coding education leaders to develop a PCO-wide strategy for coding education.
Provide coding and process education to teams of medical coders, both onshore and offshore.
Requirements:
CPC, CCS, or CCS-P Certification
6 or more years of technical experience in Physician Office Medical Coding and/or Auditing
2 or more years of Management experience
Ability to travel both locally and overnight
About Us
CenterWell Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment, and more. Our unique care model focuses on personalized experiences, taking time to listen, learn, and address the factors that impact patient well-being. We go beyond physical health by also addressing other factors that can impact a patient's well-being.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability, or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability, or protected veteran status, and to base all employment decisions only on valid job requirements.
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