Risk Adjustment Supervisor

Job Title

Job Description

Required Skills & Experience: Bachelor Degree -OR- a combination of equivalent education and work experience Medicare/Medicaid experience as it pertains to audits, claims submissions, and claims payments Experience as CPC, CCS, RHIT, or RHIA with a health care provider or health insurance company 2+ years as a Supervisor or Manager overseeing a team of 3+ people Experience in risk adjustment coding Current certification as a professional coder (CPC) Vaccinated for Covid

Can be fully remote in one of the following states: Oregon, Washington, Alaska, Montana, California, Texas, and New Mexico

Supervises and performs a wide range of activities pertaining to the review and coding of inpatient and outpatient medical record information Responsible to execute the business case model and subsequent annual work plans for the coding compliance and risk adjustment work Work closely with Director of Risk Adjustment for the reporting of correct CMS and HHS data Direct internal and external certified coders in the work of medical chart review and coding applications, including managing work distribution and flows Oversee project timelines and assign work appropriately to achieve project timelines Manage team workloads and coding capacity and ensure productivity standards are met and upheld Initiate reviews and performance management for direct reports Develop and update policies and procedures for coding compliance risk adjustment related work Seek out efficiencies and facilitate the implementation of those efficiencies Identify areas of non-compliance for diagnoses coding and establish appropriate education and interventions with coding team Perform coding and abstraction duties Participate in prospective and retrospective coding reviews Oversee and participate in RADV and other regulatory audits Adhere to and manage strict project timelines for retrospective reviews and RADV audits Maintain the foundation of compliance for all work performed within department Work with team members to understand and support professional growth goals and aspirations Create professional development opportunities within the team to support Caregiver growth