Quality Assurance Manager

Job Summary

Overseeing the quality assurance program for retrospective coding and auditing operations, the full-time Quality Assurance Manager will manage a team of QA Reviewers, maintain QA policies and SOPs, and drive improvements in coding accuracy while working remotely.

Key responsibilities

• Serve as an expert on ICD-10-CM coding guidelines and oversee QA Reviewers to set and review accuracy and productivity standards
• Perform QA reviews of escalated charts and lead the monthly and quarterly QA Scorecard process, ensuring findings are communicated effectively to leadership
• Partner with technology teams to define QA requirements for risk adjustment tooling and monitor performance for continuous improvement

Required qualifications

• Current relevant coding certification recognized by AAPC or AHIMA (e.g., CPC, CRC, CCS, CCS-P)
• 7+ years of experience in medical record documentation review, diagnosis coding, and/or auditing, particularly in risk adjustment coding
• Experience in developing and presenting accuracy or performance results to management and production coders
• Strong knowledge of ICD-10-CM coding guidelines and regulations
• Ability to read medical records and abstract clinical diagnosis codes from documentation