Supervisor, Risk Adjustment

Humana

2d • Remote

About The Position

Become a part of our caring community The Supervisor, Risk Adjustment conducts quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. You will work within thorough, prescribed guidelines and procedures; use independent judgment requiring analysis of variable factors to solve basic problems; collaborate with management and top professionals/specialists in selection of methods, techniques, and analytical approach. The Supervisor, Risk Adjustment reports to the Director, Quality and Risk Adjustment. You will ensure coding is accurate and properly supported by clinical documentation within the health record. You will follow state and federal regulations as well as internal policies and guidelines while analyzing coding information and medical records. You may participate in provider education programs on coding compliance. You will make decisions typically related to schedule, plans and daily operations. You will perform escalated or more complex work of a similar nature. You will typically supervise support and technical associates. You will coordinate and provide day-to-day oversight to associates. You will ensure consistency in execution across team. You will hold team members accountable for following established policies. Use your skills to make an impact

Requirements

• 1 or more years of experience with training, mentoring, or coaching
• Experience with medical records and/or records retrieval
• Experience working with electronic medical record (EMR/EHR) systems
• Strong knowledge of ICD-10 coding
• Demonstrated ability to articulate ideas effectively in both written and oral forms
• Proficiency in Microsoft Office Programs including Word, PowerPoint, Excel, Access, etc.
• Strong analytical, organizational and time management skills

Nice To Haves

• Bachelor's Degree
• CPC (Certified Professional Coder) Certification
• 1 or more years of supervisory experience
• Experience working in healthcare/managed care environment
• General understanding of economic, financial and operational concepts
• Longevity working in an operational setting

Responsibilities

• conducts quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies
• ensure coding is accurate and properly supported by clinical documentation within the health record
• follow state and federal regulations as well as internal policies and guidelines while analyzing coding information and medical records
• participate in provider education programs on coding compliance
• make decisions typically related to schedule, plans and daily operations
• perform escalated or more complex work of a similar nature
• supervise support and technical associates
• coordinate and provide day-to-day oversight to associates
• ensure consistency in execution across team
• hold team members accountable for following established policies

Benefits

• Health benefits effective day 1
• Paid time off, holidays, volunteer time and jury duty pay
• Recognition pay
• 401(k) retirement savings plan with employer match
• Tuition assistance
• Scholarships for eligible dependents
• Parental and caregiver leave
• Employee charity matching program
• Network Resource Groups (NRGs)
• Career development opportunities

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees