Coding Quality Assurance (QA) Manager, Remote

3 hours, 2 minutes ago
Full-time
Lead
Quality Assurance and Testing
Aledade

Aledade

Aledade collaborates with independent practices, health centers, and clinics to establish and manage Accountable Care Organizations (ACOs) that prioritize primary care, enabling physicians to enhance patient care while maintaining their independence in...

Health Care Providers & Services
1K-5K
Founded 2014
$686M raised

Description

  • Lead, mentor, and manage QA Specialists by setting goals, monitoring productivity, conducting performance reviews, and promoting continuous learning.
  • Oversee and perform coding quality audits for internal CDI teams and external vendors using ICD-10-CM guidelines and risk adjustment models.
  • Design, implement, and maintain SOPs, audit workflows, scoring methodologies, and coding quality guidelines.
  • Serve as a subject matter expert during RADV, Medicare, Commercial, and other payer audits.
  • Support chart selection, documentation review, dispute preparation, and appeal responses for payer audits.
  • Evaluate vendor accuracy against SLAs, identify error trends, provide feedback, and oversee corrective action plans.
  • Translate audit findings into targeted education and feedback for CDI specialists and vendor partners.
  • Perform other duties as assigned.

Requirements

  • Bachelor’s degree in healthcare management, nursing, or a related field, or an associate degree with relevant CDI, coding, coding management, or HCC risk adjustment experience.
  • At least 4 years of HCC coding experience, including 2 years in coding quality assurance, auditing, or compliance monitoring.
  • Active AAPC and/or AHIMA credential such as CRC, CCS, CPC, or CPMA.
  • Expertise in ICD-10-CM coding, CMS risk adjustment guidelines, RADV audit rules, and clinical documentation requirements.
  • CRC certification preferred.
  • Experience with value-based care models, ACOs, or Medicare Advantage plans preferred.
  • Experience managing small teams or leading vendor oversight programs preferred.
  • Strong leadership, communication, organizational, and mentoring skills.
  • Proficiency with EHR systems and encoder software preferred.
  • Ability to work remotely from anywhere in the United States across all US time zones.

Benefits

  • Remote work and flexible schedules for eligible roles.
  • Health, dental, and vision insurance covered up to 80% for employees, dependents, and domestic partners.
  • 21 days of PTO in the first year, plus 11 paid holidays and two paid volunteer days.
  • 12 weeks of paid parental leave for all new parents.
  • Six-week paid sabbatical after six years of service.
  • Educational assistance and clinical employee reimbursement programs.
  • 401(k) with up to a 4% company match.
  • Stock options.

Interested in this position?

Apply directly on the company website

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