BlueCross BlueShield of Western New York

About BlueCross BlueShield of Western New York

 

Job Category:

Audit/Quality/Compliance

Country:

United States

Postal Code:

14201

Approximate Salary:

Not Specified

Position Type:

Full Time

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Supervisor, Risk Adjustment Coding

Posted: 10/5/2018

Auto req ID 1964BR Company BlueCross BlueShield of WNY About Us BlueCross BlueShield of Western New York is a division of HealthNow New York Inc., one of New York’s leading health care companies that provides access to quality health care and solutions for members throughout Upstate New York. Since 1936, BlueCross BlueShield has helped millions of people gain access to health care. Headquartered in Buffalo, NY, the company is an independent Licensee of the BlueCross BlueShield Association. As the region’s leading health plan, serving over 800,000 members, BlueCross BlueShield believes in taking small steps towards healthier living. You can visit our website at www.bcbswny.com. Title Supervisor, Risk Adjustment Coding Position Posting Location Albany/Buffalo Status Full Time Regular Hours 8-5 Job Description The Supervisor, Risk Revenue will provide direction and support for retrospective and prospective risk revenue initiatives, medical record retrieval, regulatory audit coordination, provider education opportunities, and encounter reporting for the Risk Revenue department. Duties include monitoring daily productivity, quality, and training of team members, with a focus on compliance with all applicable Federal, State, and/or County coding regulations and documentation guidelines (ICD-10) for risk adjustment. The incumbent will also provide the day-to-day operational leadership of the Risk Adjustment Medical Auditor Coding department team. Primary Responsibility - Supervises daily coding operations including monitoring of productivity and chart review assignments
- Reviews coding quality assessments and provides feedback to coders
- Develops, monitors, and controls staff coverage strategies to maintain consistent productivity flow
- Meets or exceeds organization’s department productivity goals
- Researches and monitors healthcare regulatory and coding guidelines and makes recommendations to update the departmental coding guidelines, as necessary
- Supports team members through discussion of complex coding cases, answering questions, providing education, and interfacing with leadership
- Coordinates and communicates regulatory audit activity and outcomes to internal and external stakeholders; able to meet strict regulatory deadlines
- Identifies provider education opportunities to improve diagnostic documentation and implements strategy to meet with and disseminate information to the provider community
- Assists with coordination of medical chart retrieval efforts and secures access to proprietary electronic medical record software (EMRs)
- Establishes performance goals and deadlines for assigned team in accordance with company objectives
- Monitors employee productivity and provides appropriate coaching and feedback
- Organizes, prioritizes and assigns workflow and ensures that employees understand their duties and delegated tasks
- Maintains accurate timekeeping and recordkeeping
- Participates in new employee selection processes and conducts new hire training
- Monitors employee productivity and provides appropriate coaching and feedback
- Ensures compliance with departmental and company policies and procedures
- Performs other duties as required
Knowledge and Skills - Certified in ICD-10 and experience with CMS and HHS data and risk adjustment processes
- Proficient in Microsoft applications
- Demonstrated problem prevention / problem solving skills
- Well organized, paying close attention to detail
- Strong verbal and written communication skills
- Outstanding project management skills with an action/results orientation and strong relationship building skills
- Ability to handle sensitive and proprietary information in a highly confidential manner
- Demonstrated personal accountability and ability to manage multiple assignments simultaneously while maintaining quality standards and meeting assigned deadlines
- Ability to work in a fast-paced, collaborative environment with minimal supervision
- Comfortable working with individuals at all levels within an organization
- Ability to lead teams to execute strategies and tactics to meet corporate objectives
- Ability to objectively analyze facts and form judgements
Experience - A minimum of 2 years of experience required in ICD-10 coding
- HHC Risk Adjustment coding experience preferred
- 2 years of leadership experience preferred
Education Required Education:
- Associates Degree in Business, Finance, Health Information Management, or related area of study required
Certification Certified Coding Specialist (CCS, CPC, CCS-P) or Registered Health Info Tech/Admin (RHIT or RHIA) Working Conditions - Travel among Provider offices, as required
- Manual Dexterity Req: Eye-hand coordination and manual dexterity sufficient to effectively use a computer with all its components for prolonged periods of time and for the majority of required tasks
- Manual Dexterity Req: Eye-hand coordination and manual dexterity sufficient to effectively utilize various office equipment (phone, computer, fax machine, printer, copier, filing cabinet, etc.)
- Must be able to accommodate local travel
- Valid drivers license and acceptable driving history required due to travel involved with this position (DMV check will be conducted to review candidate's driving record)
- Must be able to accommodate regional travel. (DMV check will be conducted to review candidate's driving record)
- Must be able to accommodate regional/national travel (auto or air)
- Mental effort: Adequate to perform essential functions of the job with the type of judgements and responsibilities as indicated in the job description
- Heat, light, air, space and working environment typically found in an office environment
- Weight: lift/carry/push/pull under 10 lbs. Reaching
EEO Statement All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status. Removal Date 04-Sep-2019

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