Manager, Clinical Documentation and Coding Accuracy
Wellvana
full-time
Posted on:
Location Type: Office
Location: Tennessee • United States
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About the role
- Lead risk adjustment coding reviews, audits, and education programs that drive coding accuracy, regulatory compliance, and clinical documentation improvement (CDI) across the organization
- Conduct regular audits of risk adjustment coding/auditing practices, identify gaps, and provides targeted training and support to resolve them
- Analyze coding data to detect trends, patterns, and compliance risks, then translate findings into actionable improvements that reduce errors and strengthen risk adjustment practices
- Monitor changes in coding regulations and policies, and ensure timely organizational compliance
- Design and deliver coding education programs for staff and clients covering CDI, coding best practices, and regulatory compliance
- Define key metrics and performance indicators, monitor operating results, and drive corrective action/performance coaching when targets are not met
- Lead recruitment, onboarding, and ongoing development of coding/auditing staff, ensuring performance management practices align with applicable laws and regulations
- Own escalated coding/auditing and compliance issues through to timely, appropriate resolution
- Partner with internal departments to align on service standards and support consistent, high-quality coding/auditing outcomes
- Document and improve coding/auditing processes and workflows to increase efficiency and consistency
- Track and report on coding/auditing performance metrics, ensuring full adherence to policies and governmental and HIPAA compliance requirements
- Handle all Protected Health Information (PHI) in strict accordance with HIPAA requirements
Requirements
- Bachelor’s degree in a related field and/or the equivalent combination of training, education, and/or experience, required
- Certified coding credential from AAPC or AHIMA required; CPMA, CDEO, or CRC strongly preferred
- 3+ years of coding/auditing management/leadership experience required; 5+ years in multi-facility and/or vendor risk adjustment and quality operations strongly preferred
- Expertise in consulting, process reengineering, shared services, and project management within risk adjustment and quality assurance programs
- Proficiency in MS Office; ability to quickly learn job-specific software systems
- Clear and effective verbal and written communication skills
- Strong analytical and problem-solving skills, with the ability to translate data into actionable decisions
- Meticulous attention to detail with a consistent commitment to accuracy in risk adjustment and quality
Benefits
- Health insurance
- 401(k) matching
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
risk adjustment codingcoding auditsclinical documentation improvementdata analysisperformance metricsprocess reengineeringproject managementcoding best practicesregulatory complianceHIPAA compliance
Soft Skills
leadershipcommunicationanalytical skillsproblem-solvingattention to detailtraining and supportperformance managementcollaborationcoachingorganizational skills
Certifications
Certified coding credentialCPMACDEOCRC