Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first.We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.
This position is fully remote - anywhere in the U.S.The Manager, Coding will be accountable for successfully managing the Medical Coding team, audit documentation and coding practices to ensure accuracy in the data provided to CMS. The Manager will provide coding expertise as well as administrative oversight to ensure successful integration of AHC's HCC initiatives.
General Duties/Responsibilities (May include but are not limited to):
- Monitors coding & abstracting productivity and quality to ensure coding quality & performance improvement standards are maintained, achieved & improved.
- Establish performance guidelines in terms of quality and productivity measures
- Manage and maintain a comprehensive tracking and management tool for Coding workload and prioritization.
- Manage Coding activities for all assigned coders and ensure that all tasks are completed in a timely manner.
- Maintain a comprehensive tracking and management tool for assigned IPA’s within Alignments Healthcare provider network.
- Ensures compliance with all applicable federal, state &local regulations, as well as with institutional/organizational standards, practices, policies & procedures.
- Assist with CMS Data Validation activities, including suggested record selections, tracking and submission, in conjunction with Risk Adjustment leadership team.
- Keep updated on new statutes/regulations/policies and distribute updates as required
- Provides guidance in the coding/abstraction, production, and quality assurance, auditing and training activities
- Ability to work independently in a fast-paced environment
- Excellent verbal, written, and interpersonal communication skills
- Dependable, great attitude, highly motivated and a team player
- Possess strong organizational skills and attention to detail
- Other duties as assigned to meet the organization’s needs.
- Some travel as necessary (>10%)
Supervisory Responsibilities:
Oversees assigned staff. Responsibilities include: recruiting, selecting, orienting, and training employees; assigning workload; planning, monitoring, and appraising job results; and coaching, counseling, and disciplining employees.
Minimum Requirements:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.The requirements listed below are representative of the knowledge, skill, and/or ability required.Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Minimum Experience:
Three-five years of coding in a medical group or health plan setting required; Professional Coding experience required.
Previous use of EMR systems
Proficient user in MS office suite
Education/Licensure:
Bachelor’s degree in Business Administration, health Care Management or in a related field or equivalent experience desired.
Certified Coder required, CCS, CCS-P, CPC, Certified Auditor a plus.
Other:
Experience with strategic planning in risk mitigation.
Work Environment
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Essential Physical Functions:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus
Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran.
If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact careers@ahcusa.com.
Pay Range: $98,550.00 - $147,825.00Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.
Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.
*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email careers@ahcusa.com.
