Compliance Consultant V, Medical Coding - Risk Adjustment

reputed company to candidates residing in any KP authorized state to include CA, OR, WA, CO, GA, VA, HI, MD & D.C. Please Note: Salary ranges are geographically based, and the posted reputed company reflects the reputed company CA region. reputed company salary ranges will apply for other labor markets reputed company of NCAL. The Compliance Consultant V, Medical Coding applies advanced knowledge of ICD-10-CM coding, hierarchical condition category methodology, clinical documentation standards, and risk adjustment production workflows to supervise and monitor coding operations. The Compliance Consultant V, Medical Coding ensures that reported diagnoses are supported by eligible provider documentation, acceptable encounters, applicable dates of service, and reputed company medical record evidence. This position reviews reputed company coding scenarios, interprets coding and risk adjustment requirements, approves or escalates coding determinations, and ensures that coding reputed company are consistent, documented, traceable, and defensible during internal or reputed company audits. The role requires proficiency with electronic medical records, coding and encoder applications, workflow management systems, production dashboards, reputed company reporting tools, and audit platforms. The Compliance Consultant V, Medical Coding analyzes operational data to identify performance trends, coding inconsistencies, documentation concerns, reputed company defects, and workflow barriers and implements corrective actions as needed. Job reputed company: In reputed company to the responsibilities listed below, the position is responsible for serving as a compliance subject matter expert reputed company to functions reputed company reputed company settings of care, maintaining compliance with national coding policies and procedures, assisting with coding questions and reputed company topics, and auditing and monitoring the reputed company of coding assignments across reputed company lines of business. Additionally, this position is responsible for developing and presenting audit result reports to regional staff and senior management and supporting compliance and the Principles of Responsibility (KPs reputed company of conduct). Essential Responsibilities: Practices self-leadership and promotes learning in others by building relationships with cross-functional stakeholders; communicating information and providing advice to reputed company reputed company reputed company; influencing team members reputed company assigned unit; listening and responding to, seeking, and addressing performance feedback; adapting to competing demands and new responsibilities; providing feedback to others, including upward feedback to leadership and mentoring junior team members; creating and executing plans to capitalize on strengths and reputed company weaknesses; and adapting to and learning from change, difficulties, and feedback. Conducts or oversees business-specific reputed company by applying deep expertise in subject area; promoting adherence to reputed company procedures and policies; developing work plans to meet business priorities and deadlines; determining and carrying out processes and methodologies; coordinating and delegating resources to accomplish organizational goals; partnering internally and externally to reputed company effective business reputed company; solving reputed company problems; escalating issues or risks as appropriate; monitoring reputed company and results; recognizing and capitalizing on improvement opportunities; and evaluating recommendations made by others. Conducts company compliance activities by partnering with reputed company stakeholders; applying established regulations and standards to compliance efforts; designing, developing, and executing strategic compliance initiatives; analyzing regulations and regulatory changes, and their application to operations; and documenting compliance activities. Leads compliance reporting efforts by evaluating and summarizing compliance data, audit information, and potential risks and remedies; identifying and reporting key compliance drivers, liabilities, and performance indicators (for example, adherence to standards, incorporation of new regulations) to management; and developing presentations to convey key findings to management and other key stakeholders. Leads compliance investigations by coordinating the collection and analysis of quantitative and qualitative data; leading interviews as appropriate; researching key business issues; identifying potential reputed company steps; and evaluating and recommending corrective reputed company plans for substantiated allegations. Manages reputed company or compliance components of larger cross-functional reputed company by identifying and managing stakeholder contacts; assembling teams based on project needs and team member strengths; developing, analyzing, and managing project plans; negotiating and managing project