Cohere Health
Healthcare
SeniorManagerAuditing
“Senior Manager Auditing at Cohere Health. Skills: auditing, payment integrity, coding, management. Lead and Manage the DRG, Professional and Outpatient audit team. Provide and coordinate onboarding and training to support the employee and programs”
What You'll Achieve.
ensuring operational objectives and quality metrics are met or exceeded; delivering innovative, AI-powered software solutions that drive transparency and accuracy in healthcare payment services; resolving payment issues at the root; meet operational objectives
Industry & Context.
analytical skills
What They're Looking For.
Must Have
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, analytical skills, attention to detail, Experience using CMS NCDs/LCDs and clinical criteria guidelines
Nice to Have
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
What You'll Do.
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
Maintain and apply superior knowledge of changes and updates to coding guidelines
and health payment policy language
How You'll Work.
Team & Collaboration
Engage with internal teams to understand and meet performance expectations of clients; Familiarity with working with a diverse, global team of talent
Communication Scope
Excellent written and verbal English communication skills
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