Supervisor, Risk Adjustment Coding
Steward Health Care Network (SHCN) takes pride in its community-based care model, which drives value-added tools and services to our communities, patients, physicians, and hospitals across the continuum of care. In addition, Steward Health Care Network promotes care coordination and collaboration within the network in order to provide high-quality, efficient care to patients. With Steward in the community, all residents can be sure that there is a world class doctor close to where they live.
The network is also responsible for the implementation and execution of our managed care contracts, medical management services, quality improvement programs, data analysis, and information services.
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.
- 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
Job Status: Full Time
Job Reference #: 2386