Opportunity Overview:

We are seeking a Senior Manager to lead our auditing team, and provide quality control functions, ensuring operational objectives and quality metrics are met or exceeded. You will leverage your deep auditing expertise and leadership skills to inspire a high-performing team and contribute to delivering innovative, AI-powered software solutions that drive transparency and accuracy in healthcare payment services. This is a pivotal role that offers the ability to make a substantive mark on the company's growth and its commitment to resolving payment issues at the root.

What you’ll do:

• Lead and Manage the DRG, Professional and Outpatient audit team. Provide and coordinate onboarding and training to support the employee and programs. ]
• Complete audits and quality reviews as needed, ensuring compliance with coding guidelines and client requirements.
• Complete provider dispute audits.
• Provide quality and quantity reporting for the auditing team's performance to meet operational objectives.
• Engage in hiring and training activities, including conducting auditor interviews and providing ongoing internal team education and support.
• Engage with internal teams to understand and meet performance expectations of clients. May engage with clients.
• Maintain and apply superior knowledge of changes and updates to coding guidelines, reimbursement trends, and health payment policy language.

What you’ll need:

Must-haves

• Bachelor’s degree.
• 10+ years of Inpatient coding, auditing, and quality review experience in payment integrity.
• 3 years of supervisory/management experience, including supervising and training in a remote work environment.
• CCS (Certified Coding Specialist) credential.
• Superior knowledge of ICD-10-CM/PCS coding, MSDRG and APRDRG, and US healthcare payment methodologies for Commercial, Marketplace, Medicare, and Medicaid.
• Excellent written and verbal English communication skills, strong analytical skills, and attention to detail.
• Experience using CMS NCDs/LCDs and clinical criteria guidelines.

Nice-to-haves

• Experience working in a start-up or high-growth company environment, demonstrating agility and adaptability.
• Familiarity with working with a diverse, global team of talent.
• Excellent computer skills and familiarity with a Mac.
• CPC certification in addition to CCS.

Pay & Perks:

💻 Fully remote opportunity with about 10% travel

🩺 Medical, dental, vision, life, disability insurance, and Employee Assistance Program

📈 401K retirement plan with company match; flexible spending and health savings account

🏝️ Flex Time Off + company holidays

👶 Up to 14 weeks of paid parental leave

🐶 Pet insurance

The salary range for this position is $125,000 - $140,000 annually; as part of a total benefits package which includes health insurance, 401k and bonus. In accordance with state applicable laws, Cohere is required to provide a reasonable estimate of the compensation range for this role. Individual pay decisions are ultimately based on a number of factors, including but not limited to qualifications for the role, experience level, skillset, and internal alignment.

Interview Process*:

1. Connect with Talent Acquisition for a Preliminary Phone Screening
2. Meet your Hiring Manager!
3. Case Assessment
4. Behavioral Interview(s)

*Subject to change

About Cohere Health:

Cohere Health’s clinical intelligence platform delivers AI-powered solutions that streamline access to quality care by improving payer-provider collaboration, cost containment, and healthcare economics. Cohere Health works with over 660,000 providers and handles over 12 million prior authorization requests annually. Its responsible AI auto-approves up to 90% of requests for millions of health plan members.

With the acquisition of ZignaAI, we’ve further enhanced our platform by launching our Payment Integrity Suite, anchored by Cohere Validate™, an AI-driven clinical and coding validation solution that operates in near real-time. By unifying pre-service authorization data with post-service claims validation, we’re creating a transparent healthcare ecosystem that reduces waste, improves payer-provider collaboration and patient outcomes, and ensures providers are paid promptly and accurately.

At Cohere Health, Payment Integrity isn’t just about catching errors—it’s about transforming how healthcare dollars are spent to ensure accuracy, fairness, and better outcomes for everyone. By combining advanced analytics, clinical expertise, and cutting-edge technology, the team works at the intersection of healthcare and innovation to proactively identify opportunities, reduce waste, and strengthen trust between payers and providers. Joining this mission means being part of a forward-thinking organization that values curiosity, collaboration, and impact—where your work directly contributes to a more efficient healthcare system and helps ensure patients receive the right care at the right time and providers receive the right payment.

Cohere Health’s innovations continue to receive industry wide recognition. We’ve been named to the 2025 Inc. 5000 list and in the Gartner® Hype Cycle™ for U.S. Healthcare Payers (2022-2025), and ranked as a Top 5 LinkedIn™ Startup for 2023 & 2024. Backed by leading investors such as Deerfield Management, Define Ventures, Flare Capital Partners, Longitude Capital, and Polaris Partners, Cohere Health drives more transparent, streamlined healthcare processes, helping patients receive faster, more appropriate care and higher-quality outcomes.

The Coherenauts, as we call ourselves, who succeed here are empathetic teammates who are candid, kind, caring, and embody our core values and principles. We believe that diverse, inclusive teams make the most impactful work. Cohere is deeply invested in ensuring that we have a supportive, growth-oriented environment that works for everyone.

We can’t wait to learn more about you and meet you at Cohere Health!

Equal Opportunity Statement:

Cohere Health is an Equal Opportunity Employer. We are committed to fostering an environment of mutual respect where equal employment opportunities are available to all. To us, it’s personal.

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