DaVita Sr. Manager, Coding & Auditing in ST. PETERSBURG, Florida
Sr. Manager, Coding & Auditing
DaVita Medical Groupmanages and operates medical groups and affiliated physician networks inCalifornia, Nevada, New Mexico, Florida, Colorado and Washington in its pursuitto deliver excellent-quality health care in a dignified and compassionatemanner. As of June 30, 2016 DaVita Medical Group (formerly HealthCare Partners)provided integrated care management for approximately 760,000 patients. DaVitaMedical Group’s leadership development initiatives and social responsibilityefforts have been recognized by Fortune, Modern Healthcare, Newsweek andWorldBlu.
We are committed tobringing the benefits of coordinated care to our patients and to taking aleading role in the transformation of the national healthcare delivery systemto assure quality, access, and affordable care for all.
If you're looking tomake a difference with a large, financially stable, well-recognized medicalgroup, DaVita Medical Group may be the employer for you
We are currently seekinga Sr.Manager, Coding and Auditing to join our team!
Responsible for administration and oversight of the analytical andoperational activities designed to ensure appropriate practices related toCoding & Auditing activities.
* Essential Functions: *
Consistently exhibitsbehavior and communication skills that demonstrate Davita Medical Group’s (DMG)commitment to superior customer service, including quality care and concernwith each and every internal and external customer.
Manages team working onICD Coding Audits, RADV, CPT Coding audits and overall education and generalsupport of Corporate Coding & Auditing activities.
Collaborates withMedical Management on key physician activities and provider relations andClinical Network Liaisons on Coding & Auditing activities.
Interprets, providesfeedback and acts as subject matter expert of CMS regulations, Documentationguidelines, Health Plan Guidance and HCC reimbursement methodologies.
Generates variousanalytical reports and prioritization and other analytical schedules related tocorporate programs.
Assists in the designsand maintenance of the Auditing databases related to efficient and effectiveprocesses and utilizes and integrates data warehouse data as appropriate.
Provides administrativeoversight of the chart review program
Participates in qualityassurance programs: generates and reviews reports; produces executive summariesand areas for improvement
Participates in processimprovement of CHAPs Programs.
Works with Dept. Managerto orient new teammates and provides training on work processes.
Uses, protects, anddiscloses DMG patients’ protected health information (PHI) only in accordancewith Health Insurance Portability and Accountability Act (HIPAA) standards.
Creates and Maintainsdepartmental Policies and Procedure
Performs additionalduties as assigned.
- CPC certified and CPMA isrequired
Over 5 years and up to:including 5 years of HCC activities and project management experience required.
5 to 9 years experiencein health care industry required.
- 5 years of experiencemanaging professional staff
Knowledge, Skills, and Abilities:
Proficient user ofMicrosoft Word and Excel.
Strong understanding ofthe principles governing healthcare reimbursement including ICD/ CPT coding.
Basic to intermediateknowledge of encounter flow process.
Excellent organizationaland problem solving skills.
Excellent verbal andwritten communication skills.
Ability to effectivelyinterface with staff, clinicians and management
Primary Location FL-ST. PETERSBURG - 33702
Req ID: 303881