Senior Analyst, Quality

Job Description: • Responsible for conducting complex audits, reviews and assessments of medical records coded by internal teams prior to submission to CMS • Contributes to compliance reporting and documentation, highlighting findings, recommendations, and areas of concern to coding resources • Applies coding judgment and makes decisions using industry-standard evidence and tools • Confidently communicates evidence across internal or external stakeholders in written or verbal forms • Acts as mentor to provide education to internal staff based on audit findings • Communicates with corporate legal and compliance teams for accurate and timely reporting to external authorities • May liaison with regulatory bodies, auditors, and legal professionals for compliance-related matters • Demonstrates commitment to enhancing and promoting quality Requirements: • Minimum of 5 years recent and related experience in medical record documentation review, diagnosis coding, and/or auditing • Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories (HCC) required • Completion of AAPC/AHIMA training program for core credential (CPC, CCS-P) with associated work history/on the job experience equal to approximately 5 years for CPC • CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist-Physician) and CRC (Certified Risk Adjustment Coder) required • CPMA (Certified Professional Medical Auditor) or CDEO (Certified Documentation Expert Outpatient) preferred • Computer proficiency including experience with Microsoft Office products (Word, Excel, Access, PowerPoint, Outlook, industry standard coding applications) • Experience with International Classification of Disease (ICD) codes required Benefits: • Affordable medical plan options • 401(k) plan (including matching company contributions) • Employee stock purchase plan • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching • Paid time off • Flexible work schedules • Family leave • Dependent care resources • Colleague assistance programs • Tuition assistance • Retiree medical access Apply tot his job Apply To this Job