• Utilize risk adjustment coding/HCC and HEDIS expertise to perform quality reviews on internal/subcontracted HCC coders/OP CDI. • Use audit tool to analyze quality results and track overall quality. • Provide necessary feedback and research to HCC Coder/ OP CDI in response to coding and documentation questions. • Ability to assess queries for compliance and appropriate composition based on the AHIMA Query Practice Brief. • Prepare and deliver training on HCC documentation requirements, customized to the client audience (e.g., providers, HCC coders). • Assess HCC coders/OP CDI chart reviews for missed documentation or query opportunities impacting RAF scores/HEDIS measures. • Review charts to assure clinical documentation supports MEAT requirements and identify trends in documentation gaps. • Provide education to HCC Coders/OP CDI as needed based on audit findings. • Identify trends and perform training to improve HCC capture, HEDIS measure review, and quality. • Work with Manager to identify performance needs of Coders/OP CDI and create training to increase performance levels.

• Participate in internal audit engagement planning, reporting, scoping, execution and follow-up. • Act as central liaison between external audit and the business for Sarbanes Oxley (SOX) field work, manage projects to maximize productivity of audit and minimize impact to the business • Establish and lead workstreams to ensure SOX tasks, including control documentation, are maintained and completed timely • Perform testing of business process and IT controls, including obtaining, analyzing, and evaluating accounting and IT documentation, reports, data, flowcharts, etc. • Leverage previous SOX experience and be an expert on topics such as information produced by entity / key reports, entity-level controls, and other audit considerations • Establish processes to communicate internal control gaps to relevant parties and manage remediation to closure. • Evaluate automated information processing systems, related non-automated processes and the interfaces among them. • Other duties as assigned.

• Reviewing encounters in either a prebill or retrospective workflow to validate a coding profile. • Performing quality coding reviews or audits within established departmental productivity and accuracy standards. • Providing written summary reports of findings. • Coordinating and leading feedback sessions based on recommendations. • Maintaining appropriate open communication with internal and external partners and peer departments. • Assisting peer departments with production coding of cases. • Helping improve data quality for reporting and research.

• Conducts clinical coding audits according to operational guidelines • Coordinate and oversee coder onboarding process for assigned clients • Monitor and enforce compliance and quality programs • Ensure adherence to State and National Practice Standards for coding • Work directly with coding management team to ensure the educational needs of coders are met • Conduct coding audits adhering to nationally recognized coding guidelines and standards • Generate narrative audit summary reports as needed