CIOX Health Talent Acquisition

Manager, Risk Adjustment Coding Quality

Job Locations US-Remote
Posted Date 3 weeks ago(1/8/2021 5:13 PM)
Requisition ID
# of Openings
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.


  • Status: Full-time
  • Location: Remote
  • Benefits: Medical, Dental, Vision, Life Insurance, 401K Savings Plan, Unlimited PTO, and Tutition Reimbursement


  • 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.
  • Mentoring of quality and audit supervisors and audit staff to business values and coding operations KPI’s
  • Apply knowledge and expertise in use of NLP and AI technology in coding business
  • Report to coding leadership on business trends and project coding patterns
  • Collaborate with coding production to achieve 95% coding quality accuracy at project level



  • 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)


Working conditions


Over 90% of the time is spent indoors, with protection from weather conditions.  Exposure to noise levels that may be distracting or uncomfortable is present in only unusual situations. Business related travel up to 20%.


Physical requirements


Sitting, talking, hearing and near vision are required over 90% of the time, while walking is required about 10% of the time.  Standing is required over 30% of the time.  The sense of touch is required 90% of the time and reaching is required about 50% of the time.  Bending, twisting, and climbing are required, as is far vision, but only for 10% or less of the time.  Low levels of lifting (10 pounds or less) are required about 25% of the time, while medium levels (20 to 40 pounds) of lifting and carrying are required less than 5% of the time.  High levels (52 pounds) of lifting are required under 2% of the time.  Driving is a considerable portion of the position.


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