Texas Health Resources Manager Coding and Auditing-Southwestern Health Resources Clinically Integrated Network in Dallas, Texas
Please note: Southwestern Health Resources Clinically Integrated Network (SWHR CIN) is an affiliated company of Texas Health and UT Southwestern. If hired for this position, you will become a SWHR CIN employee rather than a Texas Health or UT Southwestern employee.
Southwestern Health Resources Clinically Integrated Network, SWHR CIN, is hiring for a Manager Coding and Auditing.
Salary range is Min. $68,515/year to Max. $108,222/year – based on relevant experience
• Full time, day shift
Provides oversight of daily Hierarchical Condition Category HCC coding activities including productivity monitoring, coding review, follow-up resolution, and research
Leads the development and maintenance of department processes and procedural manuals
Identifies opportunities for revised procedures and protocols relevant to program operations to ensure efficiencies and communicates them to the Director
Reviews data analysis from supervisors for patterns and trends that identify opportunities to improve documentation
Leads the development and implementation of RAF department initiatives
Supports the director in the development and regular refresh of RAF department guidelines
Applies project management science to program initiatives
Oversees generation of weekly and monthly team production reports in accordance with RAF department guidelines
Provides oversight of departmental staff training, prioritization of work, workflows and processes
Provides real time feedback to supervisors on opportunities for optimization of training and workflows
Responsible for overall productivity of coding supervisors and coding staff
Provides oversight of coder outreach and education to providers:
Manages and monitors coder outreach and provides regular reports on provider outreach and education to the Director
Works in collaboration with QA / Education Manager to document provider outreach and education events to mitigate against provider abrasion
Oversees assessment of coder placement in physician offices to ensure efficient and effective use of coder resource
Supports the Director in development and monitoring of critical financial and operational KPIs.
Conducts weekly meetings with coding supervisors to promote a culture of accountability and transparency around performance targets and expectations
Participates in weekly RAF Operations Management Team meetings:
Supports Director in the development of agenda
Provides regular report on financial and operational KPIs
Conducts bi-annual performance reviews of coding supervisors and documents performance reviews in accordance with RAF department guidelines
Provides ongoing review, communication and education of new ICD 10 coding guidelines, Medicaid and Medicare risk adjustment program rules:
Serves as subject matter expert (SME) in HCC coding and maintains working knowledge base of CMS guidelines related to risk adjustment data validation
Participates in internal and external work councils, community events and marketing events as requested
The ideal candidate will possess the following qualifications
High School diploma or equivalent is required
Bachelor's Degree is preferred
4 years experience in health care, managed care, or insurance required
2 years management experience leading project teams with responsibility for project outcomes preferred
Licenses and Certifications
CPC, CCS or Certified Risk Coder preferred upon hire
Demonstrated history of positive client and inter-office relationship management and proactive cultivation of ongoing relationships.
Demonstrated ability to consistently and appropriately establish priorities, solve problems and adapt to expanding business needs, tight deadlines, and heavy workloads.
Demonstrated ability to motivate team and hold team accountable for results.
Demonstrated working knowledge of file transfer and audit processes related to Risk Adjustment.
Ability to manage projects with competing deadlines.
Ability to work independently in a fast-paced environment.
Basic Microsoft Office proficiency (e.g. Word, Excel, and PowerPoint).
Strong communication skills, both written and oral.
Must posses strong time management and organization skills
Employment opportunities are only reflective of wholly owned Texas Health Resources entities.
We are an Equal Opportunity Employer and do not discriminate against any employees or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.