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Manager, Coding Quality



Quality Assurance
Nashville, TN, USA
Posted on Saturday, January 20, 2024

Who You Are

You are devoted, compassionate, and enjoy being on the front lines in healthcare, changing the lives of your patients. You are passionate about getting to the root cause of a patient’s conditions, removing social determinants of healthcare, and ensuring the highest possible quality of life for those in your care. You don’t want to sacrifice quality over quantity, and you aim to provide the same level of care and commitment to your patients that you would to your own family member.

Does this sound like you? If so, we should talk.

Who We Are

We are Honest Medical Group, a groundbreaking team of health care professionals focused on making a major impact in health care. At Honest, we align every aspect of our company to support patients and providers. We are devoted to purpose and inspired by innovation. We embrace our communities and lead with kindness. We drive health improvements, create a seamless member experience, and eliminate unnecessary cost. We listen to the needs of our patients and our employees—continually working to push beyond the status quo.

For us, it’s all in an Honest day’s work.

Your Role

As a Coding Quality Manager with Honest, you will play a crucial role in ensuring the accuracy and compliance of our coding processes. Your responsibilities will include designing effective processes for reviewing Pre-Visit Planning (PVP) forms, creating job aides, policies and procedures, and identifying and implementing quality improvement action plans. You will also design and lead educational sessions and training for our coding staff as well as provide quality management oversight for third party vendors who perform coding services on behalf of Honest. You will report to the Medical Director, Clinical Quality and will lead a team of coding auditors.

Primary Functions Include:

  • Develop and design an effective process for reviewing PVP forms to ensure accuracy and compliance.
  • Review and incorporate market level and partner feedback into CDI processes toward continued process and workflow improvements.
  • Formulate comprehensive policies and procedures to guide coding practices and maintain regulatory compliance.
  • Take ownership of identifying and implementing quality improvement action plans for the coding staff to enhance overall performance.
  • Collaborate closely with Clinical Documentation Improvement (CDI) leadership to align coding practices with organizational goals.
  • Effectively communicate any identified quality concerns to management in a timely manner to facilitate prompt resolution.
  • Create educational materials, in partnership with CDI medical leadership, as needed to support ongoing training and development of coding staff.
  • Partner with training team/medical education on assurance of training toward best practices in provider documentation.
  • Maintain accurate reports and regularly assess accuracy rates for the coding staff, ensuring continuous improvement in coding processes.
  • Provide clinical quality oversight for third party vendors who provide coding services on behalf of Honest.
  • Remain up to date on best practices in accordance with the latest CMS guidelines and regulatory standards.
  • Lead and manage team of coding auditors, providing guidance, support, and fostering a collaborative and high-performing work environment. Perform other related responsibilities as required.

How You Qualify

You reviewed the Who You Are section of this job posting and immediately felt the need to read on. That makes you a match for our innovative culture.

  • Currently has approved coding credentials (e.g., CPC, CRC, CPMA)
  • Proficient at ICD-10-CM coding required
  • Proficiency in CPT/HCPCS coding preferred
  • Proficiency in E&M coding preferred
  • 5+ years of coding experience, preferably HCC coding experience
  • 3+ years of coding auditing experience
  • 2+ years management experience, with direct reports
  • Strong knowledge of official coding guidelines, coding clinic determinations, CMS and other regulatory compliance guidelines and mandates
  • Strong analytical skills and the ability to solve complex coding issues efficiently, contributing to the continuous improvement of coding accuracy
  • Ability to adapt to evolving coding standards, industry trends, and organizational requirements
  • Strong collaboration skills
  • Clear and effective communication skills to facilitate collaboration with team members, CDI leadership, and other stakeholders

How You are Supported

  • As a full-time team member, you will benefit from Honest’s exceptional total rewards package, including competitive base pay with bonuses, paid time off starting at 4 weeks for full time employees, 12 paid holidays per year, reimbursement for continuing medical education, 401k with match, health, dental, and vision insurance.
  • As a part-time team member, you will benefit from Honest’s total rewards package, including competitive base pay with bonuses, pro-rated paid time off, paid holidays, reimbursement for continuing medical education, 401k with match.
  • Family friendly policies that support paid parental leave and flexible work arrangements
  • As a team member you’ll be supported by our robust commitment to training and development that starts with onboarding and continues throughout your career with Honest
  • You will collaborate with like-minded healthcare professionals who, like you, understand the importance and value of Honest’s high-quality, value-based, care model.

Honest is an equal opportunity employer that is committed to inclusion and diversity. We take affirmative action to ensure equal opportunity for all applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, Veteran status, or other legally protected characteristics.