Senior Manager Auditing

Cohere Health

5d • Remote

About The Position

We are seeking a Senior Manager to lead our auditing team, and provide quality control functions, ensuring operational objectives and quality metrics are met or exceeded. You will leverage your deep auditing expertise and leadership skills to inspire a high-performing team and contribute to delivering innovative, AI-powered software solutions that drive transparency and accuracy in healthcare payment services. This is a pivotal role that offers the ability to make a substantive mark on the company's growth and its commitment to resolving payment issues at the root.

Requirements

• Bachelor’s degree.
• 10+ years of Inpatient coding, auditing, and quality review experience in payment integrity.
• 3 years of supervisory/management experience, including supervising and training in a remote work environment.
• CCS (Certified Coding Specialist) credential.
• Superior knowledge of ICD-10-CM/PCS coding, MSDRG and APRDRG, and US healthcare payment methodologies for Commercial, Marketplace, Medicare, and Medicaid.
• Excellent written and verbal English communication skills, strong analytical skills, and attention to detail.
• Experience using CMS NCDs/LCDs and clinical criteria guidelines.

Nice To Haves

• Experience working in a start-up or high-growth company environment, demonstrating agility and adaptability.
• Familiarity with working with a diverse, global team of talent.
• Excellent computer skills and familiarity with a Mac.
• CPC certification in addition to CCS.

Responsibilities

• Lead and Manage the DRG, Professional and Outpatient audit team.
• Provide and coordinate onboarding and training to support the employee and programs.
• Complete audits and quality reviews as needed, ensuring compliance with coding guidelines and client requirements.
• Complete provider dispute audits.
• Provide quality and quantity reporting for the auditing team's performance to meet operational objectives.
• Engage in hiring and training activities, including conducting auditor interviews and providing ongoing internal team education and support.
• Engage with internal teams to understand and meet performance expectations of clients. May engage with clients.
• Maintain and apply superior knowledge of changes and updates to coding guidelines, reimbursement trends, and health payment policy language.

Benefits

• Medical, dental, vision, life, disability insurance, and Employee Assistance Program
• 401K retirement plan with company match; flexible spending and health savings account
• Flex Time Off + company holidays
• Up to 14 weeks of paid parental leave
• Pet insurance

What This Job Offers

• Job Type: Full-time
• Career Level: Senior