Assistant Manager

Who We Are

Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country. Deployed by over 60 health plans, including many of the top 20, and representing more than 160 million lives, Machinify brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise. We’re constantly reimagining what’s possible in our industry, creating disruptively simple, powerfully clear ways to maximize financial outcomes and drive down healthcare costs.

Location: This role is full remote.

Under minimal supervision, the Assistant Manager assists the Manager to support the CVS’s.  The Assistant Manager is primarily responsible for their assigned team.  The team of Assistant Managers work collaboratively together to accomplish the goal of producing excellent, high quality DRG validation outcomes.
 

RESPONSIBILITIES:

• Exhibit leadership skills in helping CVS’s to become strong and confident individual and team members
• Monitors performance and mentors CVS’s in their team to achieve excellent quality of work and high production.  Each team member must continually meet minimal expectations.
• Assist each team member to maintain and improve their quality of work.
• Monitors work queues to assure priority cases are reviewed on time.
• Performs secondary quality reviews looking for missed opportunities.
• Assists the CVS’s by reviewing and responding to questions submitted by the CVS team.  
• Provides individual CVS education and training with the goal of increasing CVS knowledge.
• Assures appeals are responded to no later than 30 days after receipt.  Analyze appeals looking for team member trends
• Maintains awareness of and ensures compliance with coding guidelines and conventions, state and federal regulations, client specific policies and VARIS policies and procedures and shares applicable changes with appropriate individuals in the organization.
• Maintains and ensures the protection of patient information with the application of the HIPAA standards and individual client contracts and policies.
• Performs or assists with system testing and special projects as needed.
• Performs selections and identifies methods to optimize the results of the selection process.
• Performs case validations
• Performs other duties as assigned.

• National certification as Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), and/or Certified Coding Specialist (CCS).  Highly recommend ICD-10 specialized training.
• Comprehensive knowledge of the DRG structure and other health care payment methodologies and regulatory requirements.
• Minimum of five to seven years hospital inpatient coding for PPS reimbursement or at least 2 years experience performing DRG validation.
• Proven self-direction in the planning and execution of DRG validation and recovery functions.
• Demonstrated exemplary professional coding judgment.
• Confirmed effective communication in staff supervision and teaching.
• Proven operations analysis, including productivity and financial skills.
• Ability to adhere to the highest ethical standards including honesty, integrity, dedication and leadership.
• Demonstrated ability to gain support for ideas and lead others to accomplish objectives.
• Demonstrated success rate in selection of cases that result in overpayment/recovery
• Organization, flexibility and multiple task/project orientation to handle duties assigned.
• Skill in focusing on desired results, determining what is important and urgent, clarifying next steps, and delegating effectively to meet deadlines and achieve desired results.
• Must possess excellent oral, written and presentation skills.
• Demonstrated proficiency in multiple computer applications (MS Office), DRG Grouper/Pricer software, and encoder software.

EXPECTATIONS:

1.  As a salaried “exempt” employee of VARIS, Assistant Managers (AM) are expected to work at a minimum of 40 hours per week or a minimum of 80 hours every two wee