[Hiring] Risk Adjustment Supervisor @Millennium Physician Group

Role Description

Under the direction of the Risk Adjustment Manager, the Risk Adjustment Supervisor is responsible for providing first-line supervision for the Risk Adjustment Coding Specialist. Supervisor responsibilities include but are not limited to:

• Daily supervision and monitoring of quality and productivity performance
• Interviewing, hiring, and any necessary discipline of staff

This position supervises risk adjustment coding and quality assurance validation for the following programs, including but not limited to:

• Prospective medical record review
• Concurrent outpatient claim diagnosis coding
• Retrospective medical record and provider response reviews

Qualifications

• High school diploma or GED equivalent
• Current active coding credential through AAPC or AHIMA required. Preference given to those with CRC designation
• Minimum of two (2) years coding experience directly related to Hierarchical Condition Category (HCC) coding
• Minimum of one (1) year experience in a lead/senior role
• Advanced knowledge of medical terminology, abbreviations, anatomy and physiology, major disease processes, and pharmacology
• Extensive knowledge of coding conventions and payment rules as they apply to medical record documentation, billing of medical services, and health care reimbursement systems, including a comprehensive understanding of ICD-10-CM
• Advanced skills for use of MS Office (Excel, Word, Access, and PowerPoint)
• Demonstrated ability to utilize a variety of electronic medical records systems
• Ability to manage significant workload, and to work efficiently under pressure meeting established deadlines with minimal supervision
• Strong time management skills. Must possess high degree of accuracy, efficiency, and dependability
• Demonstrated ability to communicate clearly and effectively with a wide variety of individuals at all levels of the organization both verbally and written
• Demonstrated organizational and problem-solving ability
• Demonstrated experience in project completion, educational program development and/or group presentation
• Commitment to maintaining confidentiality and adhering to ethical coding standards

Requirements

• Subject matter expert for proper risk adjustment coding and CMS data validation
• Provides daily supervision of department staff and provides feedback to the Risk Adjustment Manager on exceptional and/or substandard performance
• Support Manager in efforts associated with hiring, interviewing, onboarding, and recognition and discipline of staff
• Serves as a preceptor to new employees during the orientation process
• Functions as a resource to existing staff for projects and daily work
• Facilitates ongoing training for optimal staff functioning
• Conduct audits of Risk Adjustment Coding Specialist work to validate the accuracy and completeness of diagnosis suspects, claim submission, and/or retrospective reviews
• Provides ongoing feedback to staff on areas of success and improvement opportunities
• Ensures that all members of the team are following official guidelines, policies, and standard procedures
• Counsels staff on actions required to meet minimum performance requirements
• Provides or arranges for necessary knowledge-based resources required by the department staff to meet quality and production standards
• Prepares staffing schedules to provide adequate coverage for all bodies of work
• Stay updated on changes to Medicare guidelines, coding regulations, and reimbursement methodologies to ensure compliance and accuracy in coding practices
• Develop and lead coding education and training initiatives for staff to promote consistent and accurate coding practices across the organization
• Research best practices in risk adjustment coding and reviews the professional literature for coding updates
• Evaluates, researches, and recommends enhancements to the risk adjustment program and internal coding guidelines
• Develops and helps implement new workflows and policies and procedures as needed to support new and existing department initiatives, audits, and projects
• Lead workgroups and manage project deliverables for department initiatives, audits, and provider communications
• Analyze MRA data to identify patterns and when requested assist in the development of interventions at the provider and region level
• Keeps department Manager apprised of project activities through regular written and oral status reports
• Proactively identifies risks that may hinder project success

Benefits

• Compensation Range: $63,982.00 to $95,972.00
• The anticipated base salary range represents the Company's good-faith estimate of the compensation it reasonably expects to pay for this position at the time of posting
• Actual compensation will be determined based on factors including experience, skills, qualifications, geographic location, internal equity, and business needs