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. May engage with clients.
• Maintain and apply superior knowledge of changes and updates to coding guidelines, reimbursement trends, and health payment policy language.

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