New York Licensed Medicare Coding Manager

Job Summary

Leading a team of coding professionals, the full-time Medicare Risk Adjustment Coding Manager will coordinate Risk Adjustment and Quality coding operations, ensuring documentation integrity and overseeing chart review programs while working remotely from New York, New Jersey, or Connecticut.

Key responsibilities

• Manage Risk Adjustment coding operations, focusing on documentation integrity and quality outcomes
• Oversee retrospective and prospective chart review programs and supervise coding staff
• Act as the operational liaison between Risk Adjustment and HEDIS/Quality abstraction teams to enhance coding accuracy and efficiency

Required qualifications

• CPC, CPMA, CRC, CCS-P, CCS, RHIA, or RHIT certification
• At least five years of experience in Medicare Risk Adjustment coding, including familiarity with RADV audits
• Proficiency in HEDIS measure specifications and quality gap closure operations preferred
• Strong knowledge of ICD-10 and CPT codes
• Bachelor's degree in Business Administration, Finance, or a relevant field, or equivalent work experience