Ciox Health

Manager, Risk Adjustment Coding Quality

Ciox Health

Remote, US

March 25, 2022

Manager, Risk Adjustment Coding Quality

- Job Locations: US-Remote
- Requisition ID: 2022-24614
- # of Openings: 1
- Category (Portal Searching) HCC Coding


- The Quality Manager is responsible for developing and maintaining the quality standards, metrics, policies, etc. for the Coding team.

- They will provide leadership and guidance to the Auditing team regarding activity, status, trends, coaching/feedback methods and coordination of additional resources to support coding quality.


  • Manage all aspects of the Auditing and Quality Department for remote coding teams as well as field teams as necessary.

  • Monitor and report effectiveness of training programs from research, benchmark, propose training and development opportunities to drive continuous improvement.

  • Work directly with the Training/Education Department with a focus on content development/design, training coordination and facilitation. Trends, analytics.

  • Manage all aspects of Remote Coding as well as Field Coding. Review Quality Assurance standards to include domestic and non-domestic teams.

  • Create and manage team’s daily, weekly and monthly Auditing and Quality goals to ensure that department objectives are met. Reports trends to Senior Manager of Operations weekly.

  • Work cross functionally to ensure that QA, trends and education is provided timely and accurately.

  • Approve team member’s PTO and manage staff’s time out of office while continuing to meet department Auditing and Quality goals.

  • Engage with Manager of Operations, Director of Operations, Director of Quality regarding day to day operations and issues that need to be escalated.

  • Business related travel up to 20%

  • Knowledge and expertise in use of NLP and AI technology in coding business

  • Management to coding operational KPI’s

  • Reporting to coding leadership on business trends and project coding patterns

  • Collaboration with coding production to achieve 95% coding quality accuracy at project level

  • Accountability and mentoring of quality and audit supervisors and audit staff to business values and coding operations KPI’s


  • Bachelor Degree or a minimum of five years of equivalent experience in quality and/or coding management role(s) with increasing level of responsibility.

  • A minimum of 5 years of experience in risk adjustment coding and/or auditing experience.

  • Experience with adult learning methodologies and distance learning preferred

  • Excellent written and oral communication skills.

  • Strong managerial, leadership, and interpersonal skills.

  • Outstanding organizational skills.

  • Ability to work effectively in a team environment.

  • Flexibility in work schedule to meet departmental needs.

  • Strong analytical and problem-solving skills to grasp the key points from complicated details and provide direction/ coaching to members of the team.

  • A strong knowledge base of medical terminology, medical abbreviations, pharmacology and disease processes

  • Expertise and experience in Risk Adjustment coding

  • Ability to analyze data to determine the root cause of identified quality/production concerns

  • Ability to work in a fast-paced production environment while maintaining high quality

  • Must be able to follow instructions, meet deadlines and work independently.

  • Excellent written and verbal communication skills, ability to work in a remote environment, and time management skills.

  • Working knowledge of the business use of computer hardware and software to ensure effectiveness and quality of the processing and security of the data.

  • Requires skill in the use of a wide variety of office equipment including: computer, routers, and other office equipment as required.

  • AHIMA certified credentials (RHIA, RHIT, CCS) or AAPC certified credentials (CPC, CPC-H, COC, CIC, or CRC)

To ensure the safety of patients and staff, many of our clients require post-offer health screenings and proof and/or completion of various vaccinations such as the flu shot, Tdap, COVID-19, etc. Any requests to be exempted from these requirements will be reviewed by Ciox Human Resources and determined on a case-by-case basis. Depending on the state in which you will be working, exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its components, pregnancy or pregnancy-related medical conditions, and/or religion.

For remote work, this position requires that you provide a high-speed internet connection, subject to applicable expense reimbursement requirements (if any), and a work environment free from distractions.