Manager, Coding Quality Review (Remote)

Education and Work Experience:

• Bachelor's degree or equivalent combination of education/experience: Required


• Master's degree: Preferred


• Five years' of hospital-based coding or Five years of professional fee coding experience: Required


• Two years' leadership experience: Required


• Three years of previous coding audit experience: Preferred

Licenses/Certifications:

• Certified Coding Specialist credential through AHIMA (CCS) or Certified Professional Coder (CPC) through AAPC, CPMA certification preferred: Required


• Current permanent U.S. work authorization: Required

Essential Functions:

• Manages the CQR audit/education team to ensure all regularly scheduled and ad hoc quality reviews are completed, in addition to all other team’s daily responsibilities. Ensures all coding education needs are being addressed by coordinating education initiatives to internal and external teams, as well as providing oversight for coding education library and resource materials.


• Oversees the audit appeal process to ensure the integrity and accuracy of all coding reviews. Manages respective team to ensure assigned Key Performance Indicators are met. Ensures all CQR team members maintain up-to-date knowledge of medical terminology, coding guidelines, quality standards, regulatory changes, etc. that affect the audit process.


• Develops, recommends, and oversees the implementation and administration of policies and procedures of respective area. Evaluates process and procedures and coordinates with the leadership team to ensure efficient areas of focus and adhere to federal and local laws and regulations.


• Demonstrates, through plans and actions, a consistent standard of excellence to which all department work is expected to conform. Works with cross-functional team members to identify and solve process issues. Focuses on continuous improvement working with the leaders across the health system with a goal of delivering the highest degree of quality service possible.


• Conducts recurring quality assurance audits and provides coaching sessions/performance reviews in relation to set benchmarks. Completes, reviews, manages and monitors department budget.


• Performs other job-related duties as assigned.

Organizational Requirements:

Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.


Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.