Job Information
R1 RCM Manager of Coding Compliance & Audit in Boise, Idaho
R1 is a leading provider of technology-enabled revenue cycle management services which transform and solve challenges across health systems, hospitals, and physician practices. Headquartered in Chicago, R1 is publicly traded organization with employees throughout the US and international locations.
Our mission is to be the one trusted partner to manage revenue, so providers and patients can focus on what matters most. Our priority is to always do what is best for our clients, patients, and each other. With our proven and scalable operating model, we complement a healthcare organization’s infrastructure, quickly driving sustainable improvements to net patient revenue and cash flows while reducing operating costs and enhancing the patient experience.
As our Manager of Physician/Professional Coding Compliance Audit, you will manage coding compliance audits, including risk-based audits and quality review (QR) monitoring, and will assist with performing coding audits as needed. Every day you will develop and maintain relationships with revenue cycle teams spanning all organizational levels to effectively articulate coding quality and education needs. The manager will also conduct coding research, answer coding questions, and serve as a subject matter expert in coding compliance. To thrive in this role, you must be coding certified, have leadership experience, and enjoy working with various stakeholders and clients.
You will report directly to the Director of Coding Compliance & Billing Audit.
Key Responsibilities
You will be working with several different Electronic Health Records and host billing systems and encoders as applicable to the various R1 clients.
You will help build a dedicated team of coding compliance audit professionals focusing on physician coding and billing.
Manage coding compliance audits, to include risk-based audits and QR monitoring reviews. Responsibility for planning, monitoring, following up, and escalating any concerns to ensure the coding audits within the audit work plan stay on track and are completed in within a timely manner.
Maintain audit documentation, including audit cycle steps and information within AuditBoard and provide regular updates to Audit & Risk (A&R) leadership.
Work closely with the Director of Coding Quality and Manager of Coding Education to ensure timely delivery of necessary education based on audit results; and assist in the development discussions for Corrective Action Plans (CAPs) based on audit findings.
Write announcement letters, audit reports, and follow up emails with the assistance of templates and audit resources, and distribute following review and approval by senior leaders within A&R prior to issuing.
Communicate coding audit findings to auditors, leaders, and clients, including applicable references, as appropriate.
Manage the professional/physician coding compliance auditor team, including direct people leader tasks such as timecard review/approval, PTO review/approval, work assignments, productivity monitoring, employee engagement, and general staff oversight, including keeping team informed about expectations, performance, and organizational and/or process changes.
Serve as a coding subject matter expert.
Provide guidance on documentation requirements, coding queries, and recommend process improvements.
Keep current on coding changes, specifically as they relate to physician/professional coding and billing.
Research and resolve coding and/or documentation inquiries using authoritative sources.
Assist and provide input to the Director of Coding Compliance & Billing Audit in developing the annual coding compliance audit work plan.
Assist in performing routine coding compliance audits as needed.
Collaborate with a broad spectrum of service lines and professionals, ranging from senior management to front line site and service leaders to clients and vendors.
Required Qualifications
Active coding credential: CCS, CCS-P, or CPC required. CPC-A is not applicable.
Healthcare Coding Audit experience
Previous leadership or management experience
Knowledge of federal health care program statutes, regulations, rules and guidance regarding reimbursement, condition of payments and other material requirements; and healthcare compliance audit requirements.
Experience working with multiple EMRs, systems, clients, and contracts
Successful relationship building and credibility with key stakeholders and subject matter experts in relevant service lines.
For this US-based position, the base pay range is $71,930.00 - $109,236.00 per year . Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training.
The healthcare system is always evolving — and it’s up to us to use our shared expertise to find new solutions that can keep up. On our growing team you’ll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career.
Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team — including offering a competitive benefits package. (http://go.r1rcm.com/benefits)
R1 RCM Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company’s employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.
If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at 312-496-7709 for assistance.
CA PRIVACY NOTICE: California resident job applicants can learn more about their privacy rights California Consent (https://f.hubspotusercontent20.net/hubfs/4941928/California%20Consent%20Notice.pdf)
To learn more, visit: R1RCM.com
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R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry’s most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation and workflow orchestration.
Headquartered near Salt Lake City, Utah, R1 employs over 29,000 people globally and is traded on the Nasdaq stock exchange under the symbol “RCM.”