This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.

Role Description

As a key member of the Amazon One Medical Revenue Cycle team, the Coding Compliance Auditing Manager will be responsible for supporting Amazon One Medical Clinical and Revenue Cycle teams in managing and optimizing compliant healthcare revenue cycle operations.

• Lead a team of coding compliance auditors, ensuring accurate medical coding practices and maintaining compliance with regulatory requirements.
• Demonstrate increased autonomy and strategic thinking and problem-solving skills.
• Manage, mentor, and develop a team of coding compliance auditors.
• Establish performance standards, metrics, audit schedules, comprehensive audit protocols, and monitor coding accuracy rates.
• Coordinate workload distribution and maintain productivity standards.
• Provide ongoing feedback, education, and training to team members.
• Provide guidance on challenging coding scenarios and ensure adherence to ICD-10-CM, CPT, and HCPCS coding guidelines.
• Monitor and stay current with updates to coding regulations and implement necessary changes.
• Maintain documentation of audit findings and corrective actions.

Qualifications

• 3+ years of direct leadership/supervisory experience.
• Bachelor's degree in Healthcare, Business, Human Resources, or related field.
• 5+ years of coding/auditing experience in the professional fee and/or risk adjustment setting working with Medicare, Medicare Advantage, and Commercial payers required.
• Knowledge of industry standard code sets and associated guidelines (ICD-10-CM, CPT, HCPCS).
• Possesses advanced knowledge and understanding of HCC Risk Adjustment, coding and documentation requirements.
• CPC certification through AAPC and/or CCS certification through AHIMA required.
• CPMA and CRC certification through AAPC required.

Requirements

• Experience in project management including resource planning, managing schedules, reporting project status and prioritizing own tasks and those of other team members for multiple projects.
• Strong analytical skills, attention to detail, and effective communication abilities.
• Experience working proactively and independently, meeting deadlines, and delivering on projects and tasks.
• Ability to identify and communicate trends in coding and documentation.
• Complies with policies and procedures for confidentiality of all patient records and security of systems.

Benefits

• Comprehensive health insurance (medical, dental, vision, prescription, Basic Life & AD&D insurance and option for Supplemental life plans, EAP, Mental Health Support, Medical Advice Line, Flexible Spending Accounts, Adoption and Surrogacy Reimbursement coverage).
• 401(k) matching.
• Paid time off.
• Parental leave.