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. Were constantly reimagining whats 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 CVSs. 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 CVSs to become strong and confident individual and team members
• Monitors performance and mentors CVSs 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 CVSs 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 week pay period. VARIS allows some flexibility of work schedules however AMs must work at least 5 hours per day. If less than 5 hours per day are worked prior approval must be made. Approvals have to be entered into the VARIS time off calendar. AMs must be disciplined to work independently on a remote basis and have the ability to be flexible with the possibility of working greater than an 8 hour day.

2. AMs are expected to have each team member within their team achieving at a minimum a 15% find rate and complete at least 2.0 records per validation hour worked. A skill level improvement may be performed periodically by your managerA positive skill improvement analysis does not guarantee either an increase in compensation or continuing employment. Raises if given are based on a number of factors such as VARIS LLC performance and profitability department or group performance and individual performance. (see Employee Handbook: Skill Improvement) AMs must also report as accurately as possible the total hours worked for each task.

3. Appeal responses are expected to be completed at the beginning of each work day. The time involved working on appeal responses is included within the total validation hours worked not counted separately. AMs assure that all appeals for their team are complete on time. AMs assist other AMs in achieving a quick company wide appeal response.

4. An AM assists CVSs in producing strong and high quality rationales for any coding change that affects the DRG assignment; using proper grammar spelling and punctuation. Rationales should include ICD-9-CM Coding Conventions Official Coding Guidelines and AHA Coding Clinic advice to support the DRG change. Rationale letters are written at a level that conveys professionalism and subject matter expertise.

5. An AM assists CVSs to improve their quality of work and have no more than 2 cases per month (per employee) that are identified as a CVS oversight (or A3). Focused closed case reviews must be at a minimum of 90% accuracy rate. (Refer to the Quality Monitoring Policy and Procedure dated 2/2013)

6. AMs are expected to attend monthly CVS meetings. Only exceptions are for vacation sickness or situations where prior approval has been made. If an AM misses a meeting they are required to review the team agenda and contact their Manager for important updates.

7. AMs are required to work on their coding skills on their own time to be professionally ready for their specific job at VARIS (including ICD-10).

8. AMs are expected to demonstrate commitment to the VARIS values as described in the employee handbook.

NOTE: The position expectations outlined above are in no way to be construed to be all encompassing.

This is an exempt position. The salary range is between $105000 and $110000 USD

For Salary position only:The salary range is for Base will be determined based on several factors including but not limited to skill set years of experience and the employees geographic location.

Whats in it for you

• PTO Paid Holidays and Volunteer Days
• Eligibility for health vision and dental coverage 401(k) plan participation with company match and flexible spending accounts
• Tuition Reimbursement
• Eligibility for company-paid benefits including life insurance short-term disability and parental leave.
• Remote and hybrid work options

What values well share with you

• Ask why
• Think big
• Be humble
• Optimize for customer impact
• Deliver results
  

At Machinify were reimagining a simpler way forward. This begins with our employees. We are innovators who value integrity teamwork accuracy and flexibility. We do the right thing and we listen to the needs of our clients and their members. As tenured experts with unmatched experience we champion diverse perspectives that help us to better understand and serve our clients.


Our values come to life through our culture. We embrace flexible working arrangements that allow our employees to bring innovation to life in the way that best suits their productivity. We work cross-functionally abandoning silos to bring innovative and accurate solutions to market. We invest in each other through ongoing education and team celebrations and we give back to our communities through dedicating days for volunteering. Together Machinify is making healthcare work better for everyone and were passionate about a future with better outcomes for all.

We are committed to equal employment opportunity regardless of race color ancestry religion sex national origin sexual orientation age citizenship marital status disability gender gender identity or expression or veteran status. We are proud to be an equal opportunity workplace. Machinify is an employment at will employer. We participate in E-Verify as required by applicable accordance with applicable state laws we do not inquire about salary history during the recruitment process. If you require a reasonable accommodation to complete any part of the application or recruitment process please contact our People Operations team at. See our Candidate Privacy Notice at: Experience:

Manager