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Audit Operations:
- Oversee and review audit determinations to ensure consistency in APC/APG grouping and OPPS packaging.
- Proactively identify backlogs and align resources to meet SLAs.
- Develop medical review guidelines and coding education materials.
Team Leadership:
- Supervise daily activities of outpatient coding audit staff, ensuring productivity and quality standards.
- Provide coding guidance and serve as escalation resource for complex issues.
- Conduct regular team meetings and performance reviews.
Operational Support:
- Support management with capacity planning, staffing models, and productivity standards.
- Monitor staffing levels and ensure auditors have necessary tools.
- Analyze operational metrics and report trends to leadership.
Machinify
Machinify is a leading healthcare intelligence company that delivers value, transparency, and efficiency to health plan clients. Deployed by over 85 health plans and representing more than 270 million lives, the company fosters a culture of innovation and disruption.