Coding Quality & Compliance Manager, AI-Driven Audits

Oak Street Health, part of CVS Health; Chicago (IL); On-site; USD 66,000 - 146,000; Full time

Benefits offered by this job

Paid vacation

Sick time

401K match

Health insurance

Vision & dental

Leadership development

Job summary

Oak Street Health seeks an experienced Manager of Coding Quality and Compliance to lead a skilled team responsible for coding accuracy, auditing, and regulatory compliance across Epic-driven workflows.

You will partner with Rev Cycle, Coding, Clinical Documentation, and IT leadership to design AI-enabled coding workflows, maintain audit controls, and prepare RADV readiness while ensuring AHIMA/ACDIS standards.

Qualifications

• Post secondary/technical training and current coding credentials.
• 5–7 years of risk-adjusted coding experience.
• Experience designing AI-enabled coding workflows.
• Prior medical chart auditing and quality assurance experience.
• Ability to lead a coding team and collaborate with cross-functional groups.

Responsibilities

• Conduct daily quality checks and secondary reviews for coding staff.
• Manage external audits and CMS RADV readiness activities.
• Audit provider queries and enforce AHIMA/ACDIS standards.
• Translate high-risk OIG parameters into Epic tool configurations.
• Maintain deletion logs and track 60-day overpayment reconciliations.

Skills

Medical coding

Team management

Auditing

AI workflow design

CMS RADV auditing

AHIMA/ACDIS standards

Education

CCS/CCA/CPC certification

AHIMA/AAPC credential

RHIT or RHIA preferred

Tools

Epic

Job description

Oak Street Health seeks an experienced Manager of Coding Quality and Compliance to lead a skilled team responsible for coding accuracy, auditing, and regulatory compliance across Epic-driven workflows.

You will partner with Rev Cycle, Coding, Clinical Documentation, and IT leadership to design AI-enabled coding workflows, maintain audit controls, and prepare RADV readiness while ensuring AHIMA/ACDIS standards.