Mra Director

The Director, Risk Adjustment conducts quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. The Director, Risk Adjustment requires an in-depth understanding of how organization capabilities interrelate across the function or segment. Responsibilities The Director, Risk Adjustment ensures coding is accurate and properly supported by clinical documentation within the health record. Follows state and federal regulations as well as internal policies and guidelines while analyzing coding information and medical records. May participate in provider education programs on coding compliance. Decisions are typically related to the implementation of new/updated programs or large-scale projects for the function and supporting technical/operational procedures and processes, and implements strategic plans, drives goals and objectives, and improves performance. Provides input into functions strategy. Required Qualifications Typically requires Masters Degree or equivalent, 8 years of technical and 5 years of management experience CPC (Certified Professional Coder) Certification required Preferred Qualifications Additional Information Scheduled Weekly Hours 40