Senior Manager, Program Integrity – CPC, RHIT, RHIA required

ManagerManagerFull TimeRemoteTeam 1,001-5,000Since 30+ yearsH1B SponsorCompany SiteLinkedIn

Location

United States

Posted

49 days ago

Salary

$94.1K - $164.8K / year

Bachelor Degree5 yrs expEnglish

Job Description

• Implement optimization opportunities for prepay and post pay medical record auditing procedures and processes improvement auditing timeliness and quality outcomes • Oversee and ensure that supporting business and regulatory processes and documentation exists and kept current • Track and communicate production issues and escalations to ensure proper follow-up and coordination • Maintain project plans for all projects in which configuration is involved and ensure proper completion of those plans and escalation where timeframes will be changed • Lead new product and new vendor implementations to ensure timeliness and quality of new implementations • Develop and implement ticket controls and ensure that proper communication and approvals are in place prior to system implementation • Oversight and management of team of medical record coding auditors • Analyze and make a determination of appropriate reimbursements and/or modifications of Coding review guidelines in partnership with medical directors and clinical staff.

Job Requirements

  • Bachelor’s degree or equivalent years of relevant work experience is required
  • Minimum of five (5) years of experience in medical policy is required
  • Minimum of five (5) years of management experience is required
  • Health plan experience is required
  • Facets and clinical editing system or equivalent system experience is required
  • Advanced computer skills and abilities in Facets
  • Proficient in Microsoft Suite to include, Word, Excel, and Access
  • Knowledge of regulatory reporting and compliance requirements

Benefits

  • Bonuses tied to company and individual performance
  • Substantial and comprehensive total rewards package

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