What are the responsibilities and job description for the Quality Coding Manager position at CINQCARE?
Job Description
Job Description
Why join CINQCARE?
CINQCARE is a provider-led, community-based health and care partner dedicated to improving the health and well-being of those who need care the most, with a deep commitment to Black and Brown communities. Our local physicians, nurses, and caregivers work together to serve people and the communities they live in, beyond just treating symptoms. We remove barriers by delivering personalized care as close to home as possible, often in-home, because we know a deep understanding of our patient’s race, culture, and environment is critical to delivering improved health outcomes. By empowering patients, providers, and caregivers with the support they need, we strive to make health and care a reality—not a burden—every single day.
Overview
The Quality Coding Manager will work closely and report to the department manager of risk adjustment with accountability for providing strategy, judgment, organization, and evidenced-based analysis to influence decisions, and directly to meet CINQCARE requirements. They should embody CINQCARE’s core values, including, Trusted, Empathetic, Committed, Humble, Creative and Community-Minded. At CINQCARE, we don’t have patients or customers – we have Family Members .
The Quality Coding Manager will work closely with providers, nurse practitioners, and other care team members. This position is responsible for reviewing the documentation of the clinicians and subcontractors with the goal of closing Risk Adjustment gaps, closing HEDIS care gaps, and claims reconciliation.
Primary Responsibilities
The Quality Coding Manager worker will have the following responsibilities :
- The Quality Coding Manager is responsible for researching, and analyzing the medical records for discrepancy in coding, validating the coding, and supporting the department in the reporting of findings.
- This position reviews medical records to ensure compliance with CINQCARE coding procedure and standards according to regulations from CMS.
- Coder must follow CMS, and best practice guidelines.
- Coder will confirm the diagnoses information is coded to the highest level of specificity within the medical records and on the claims reviewed.
- Ensure that sources of data from clinician, and subcontractors has the correct code and support the diagnoses within the medical record to ensure payment from CMS.
- Provide leadership updates on all coding of invalid codes.
- Complete appropriate paperwork, documentation, system entry regarding coding of encounter information
- Provide collaboration efforts with any coding related inquiries.
- Monitor coding changes to ensure that the most current information is available.
- Maintain thorough knowledge of coding audit guidelines and procedures, medical terminology, anatomy, ICD10 CM coding, and transactions for accessing data.
- Communicate and interact effectively and professionally with management, co-workers, customers etc.
- Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies, and other applicable corporate and departmental policies.
- Maintain complete confidentiality of company business.
- Maintain communication with management regarding developments within areas of assigned responsibilities and perform special projects as required or requested.
- Perform other job-related duties as assigned.
Qualifications
The Quality Coding Manager should have the following qualifications :
Our Benefits
At CINQCARE, we care for our team like we care for our patients—holistically. We offer flexible, comprehensive benefits so you can thrive while delivering top-notch care.
The working environment and physical requirements of the job include :
Work is performed indoors in a setting with conditioned air and artificial light. Travel to and work in offices or other environments is required.
In this position you will need an to communicate with customers, vendors, management, and other co-workers in person and over devices, sometimes with people who are agitated. Regular use of the telephone and e-mail for communication is essential. Sitting for extended periods is common. Must be able to receive ordinary information and to prepare or inspect documents. Lifting of up to 10 lbs. occasionally may be required. Good manual dexterity for the use of common office equipment such as computer terminals, calculator, copiers, and FAX machines. Good reasoning ability is important. Able to understand and utilize management reports, memos, and other documents to conduct business.
