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Posted: 14-Feb-25
Location: Irving, Texas
Internal Number: 253575
Summary:
The Supervisor of HCC Coding reports to the VP of Network Operations. The supervisor is responsible for supervising the team of risk adjustment auditors, delivering operational excellence, and clearly documenting the team's workflows and outcomes. Coordinates the coding activities to ensure optimization of risk adjustment revenue across CHRISTUS population health value-based contracts.
Responsibilities:
- Supervises coding team and activities for Risk Adjustment efforts, including productivity
- Conducts QA coding reviews and provides guidance to ensure accurate documentation and adherence to CMS guidelines
- Responsible for preparing, assigning tasks, monitoring workflow and monitor day to day execution and employee activities
- Identifies and communicates documentation deficiencies to providers to improve documentation for risk adjustment, including development of educational materials
- Performs all duties inherent in a supervisory role. Ensures effective staff training, interviews candidates for employment, evaluates staff performance, and recommends hiring, promotions, salary actions, and terminations as appropriate.
- Participates in special projects and performs other duties as required
- Identify corrective action plans and implement strategies related to coding findings
- Provide guidance and oversight for internal coding reviews in compliance with internal review process.
- Provide regular updates to the management on the status of their completed reviews.
- Establishes operating policies and procedures for all risk adjustment programs and processes in coordination with internal and external operational units. Ensure employees follows guidelines, policies, and procedures accordingly.
Requirements:
- Certified Professional Coder
- In depth knowledge of all regulatory processes both State and Federal
- Experience with CMS & HHS risk adjustment
- Five or more years of experience in risk adjustment
- In depth knowledge of risk adjustment methodologies for MA and ACA
- Extensive knowledge of ICD-9-CM, ICD-10-CM and CPT/HCPCS coding
- Strong planning, organizational, interpersonal, verbal, and written communication skills required
- American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC) certification required
- CRC (Certified Risk Adjustment Coder) certification, preferred
Work Type:
Full Time
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