This position that reports to the Manager of Risk Adjustment for Steward Health Care Network. Supervises the daily operational activities for the Risk Adjustment Coding team and provides education and support on risk adjustment to internal team members, Providers and Practices either in person or via skype. Monitors daily quality, productivity, and training of team members.
Essential Duties and Primary Accountabilities:
* Supervises risk coding staff and workflow including guidance and training for staff on auditing provider records for risk adjustment opportunities. Qualifications
* Review provider charts and delegate to team members to stratify strategically to capture risk adjusting conditions.
* Provide support through discussion of complex cases, answering questions, and interfacing with members of the performance leadership team
* Creates and maintains a complex tracking system to measure and monitor team and provider performance.
* Helps coordinate team and Provider improvement initiatives Reviews quality of coding staff's audits and provides feedback to coders.
* Monitors employee productivity and provides appropriate coaching and feedback
* Identifies provider education opportunities to improve documentation and helps implement and disseminate information to providers and appropriate staff.
* 1:1 Providers trainings and meetings either on site or through skype. Ensure compliance with company policies and procedures.
* Ensure compliance with language of training materials for Providers
* Participates in new employee selection processes and conducts new hire training for the Risk Coders.
* Perform other duties as requested
Education / Experience / Other Requirements
* Bachelor's degree preferred
* Certified Professional Coder (CPC) and a Certified Risk Coder (CRC)
Work Related Experience:
* A minimum of 3 years professional coding experience, 1 year in a supervisory capacity
* A minimum of 2 years' experience in risk adjustment.
* Understanding of CMS HCC Risk Adjustment, Medicaid and Commercial DxCG Risk Adjustment and data validation requirements
* Experience with creation of training documents, educational materials with compliant language
* Advanced knowledge of CPT and ICD-10 coding required
* Computer literacy of electronic medical records
* Proficiency in MS office (outlook, excel, work, PowerPoint) required
Outstanding project management skills with an action/results orientation and strong relationship building skills
Physical and Mental Demands
These physical and mental demands are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
* Professional interpersonal and organizational skills
* Attentive to detail and organization with ability to work with strict deadlines
* Strong interpersonal and communication skills: able to effectuate areas of opportunities to all levels within the organization
* Able to maintain a calm and collected presence while addressing the concerns from within the network and outside the network
* Demonstrated personal accountability and ability to manage multiple assignments simultaneously while maintaining quality standards and meeting assigned deadlines
* Ability to objectively analyze facts and form judgments