Supervisor, Risk Adjustment Coding

UHS•Reno, NV

17h

About The Position

Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience. The Risk Adjustment Coding Supervisor will be responsible for overseeing and auditing the coding team for accurate coding and reviews to ensure productivity and accuracy is maintained within all internal coding programs. The Supervisor will take an active role in developing, updating, and maintaining Prominence’s coding policy therefore must demonstrate experience and knowledge in CMS Coding and Documentation Guidelines as well HCC coding policies. The Coding Supervisor will support production coding as needed, assign and task work queues and projects to staff. The Supervisor will identify coders on the team that are not maintaining accuracy to conduct further training and set improvement plans. They will also identify opportunities for coding and documentation education for providers and work with the Prominence educator to successfully carry out trainings and education. The Supervisor will also be responsible for evaluating and assessing the department’s staffing needs, hiring, and conducting training/orientation. The Supervisor will report to the department Manager as well as assist with RADV audits, vendor relationships, and play a key role in decision making for the department to improve processes and establish better efficiencies.

Requirements

High school education or GED required.
Coding certification (CCS or CPC through AHIMA/AAPC)
ICD-10 coding proficiency
3-5 years’ experience in CMS HCC risk adjustment coding
2+ years’ experience in a managed care setting
Ability to effectively communicate in English, both verbally and in writing.
Proficient in Microsoft Office Suite, Word, Excel and Access
Excellent written and oral communication skills
Attention to the detail.
Comfortable working in a department with set productivity and coding accuracy standards

Nice To Haves

Associate's degree preferred.
RHIT and CRC certification preferred.
Billing experience is a plus.
Experience with NCQA HEDIS programs preferred.
Experience working in health care and health

Responsibilities

Overseeing and auditing the coding team for accurate coding and reviews to ensure productivity and accuracy is maintained within all internal coding programs.
Developing, updating, and maintaining Prominence’s coding policy.
Supporting production coding as needed.
Assigning and tasking work queues and projects to staff.
Identifying coders on the team that are not maintaining accuracy to conduct further training and set improvement plans.
Identifying opportunities for coding and documentation education for providers and working with the Prominence educator to successfully carry out trainings and education.
Evaluating and assessing the department’s staffing needs, hiring, and conducting training/orientation.
Reporting to the department Manager.
Assisting with RADV audits and vendor relationships.
Playing a key role in decision making for the department to improve processes and establish better efficiencies.