Code Edit Disputes Supervisor

Humana

1d • Remote

About The Position

Code Edit Disputes reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery. The Supervisor, Medical Coding works within thorough, prescribed guidelines and procedures; uses independent judgment requiring analysis of variable factors to solve basic problems; collaborates with management and top professionals/specialists in selection of methods, techniques, and analytical approach. The Supervisor, Medical Coding oversees the coding disputes team as related to schedules, plans, and daily operations. Coordinates and collaborates with Lead to ensure consistency in processes and procedures are aligned across teams. Leads continuous improvement efforts such as evaluating existing systems and implementing process improvements. Implements, monitors, and continually improves program operational processes. Rethinks routine from a standpoint of how inventory is approached, which includes viewing different aspects of the edit, actively offering new ideas to simplify or improve team processes and procedures while identifying trends by deep diving into issues to determine opportunities. Holds team members accountable for following established policies and procedures.

Requirements

• Minimum of 6 years of medical coding experience
• Minimum of 2 years of formal or informal leadership/management experience (ie team lead, SME: Subject Matter Expert)
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences
• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
• Satellite, cellular and microwave connection can be used only if approved by leadership

Nice To Haves

• STRONGLY PREFERRED: CPC (AAPC) certification
• STRONGLY PREFERRED: Code edit experience
• Bachelor's Degree
• Coding leadership experience overseeing remote staff
• Outpatient professional coding experience
• Denial management experience

Responsibilities

• Oversees the coding disputes team as related to schedules, plans, and daily operations.
• Coordinates and collaborates with Lead to ensure consistency in processes and procedures are aligned across teams.
• Leads continuous improvement efforts such as evaluating existing systems and implementing process improvements.
• Implements, monitors, and continually improves program operational processes.
• Rethinks routine from a standpoint of how inventory is approached, which includes viewing different aspects of the edit, actively offering new ideas to simplify or improve team processes and procedures while identifying trends by deep diving into issues to determine opportunities.
• Holds team members accountable for following established policies and procedures.

Benefits

• medical, dental and vision benefits
• 401(k) retirement savings plan
• time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
• short-term and long-term disability
• life insurance
• many other opportunities

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level