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Associate Director, Risk Adjustment Audit

2 months ago

Tampa, Florida, United States CenterWell Primary Care Full time
Job Title: Associate Director, Risk Adjustment Audit

Join CenterWell Senior Primary Care, a leading provider of senior-focused primary care, as we seek an experienced Associate Director, Risk Adjustment Audit to lead our risk adjustment audit team. In this critical role, you will oversee quality assurance audits of medical records, ICD-10-CM, CPT, and HCPCS codes submitted to CMS, payers, and government agencies. Your expertise will ensure accurate and compliant coding, driving business growth and patient well-being.

Responsibilities:
  • Lead a team of coding and documentation auditors to ensure accurate and compliant coding.
  • Develop and implement audit strategies to identify trends and areas for improvement.
  • Collaborate with clinical and coding education leaders to develop a comprehensive coding education strategy.
  • Provide oversight and monitoring of potential coding issues, including cancer, E&M utilization, and other areas of concern.
  • Serve as a coding resource to other teams, providing guidance and support as needed.
Requirements:
  • CPC, CCS, or CCS-P certification.
  • 6+ years of technical experience in physician office medical coding and/or auditing.
  • 2+ years of management experience.
  • Ability to travel locally and overnight.
Preferred Qualifications:
  • CEDO certification.
  • CPMA or CRC certifications.
  • Bachelor's degree in business, healthcare administration, or related field.
  • Well-versed in various reimbursement methodologies, including risk adjustment, fee for service, Medicare, and more.
About Us:

CenterWell Senior Primary Care is a leading provider of senior-focused primary care, dedicated to delivering proactive, preventive care to seniors. Our unique care model focuses on personalized experiences, taking time to listen, learn, and address the factors that impact patient well-being. Join our team and be part of an organization that puts health first.