|Skills:||coding,supervision,revenue recovery,diagnosis reporting,diagnosis accuracy,risk adjustment,risk coding,CPT,ICD-10 CM
|Required Certifications:||Registered Health Information Technician (RHIT) or Certified Professional Coder (CPC or other coding certification) and/or obtain within one year of hire.
|Preferred Certifications:||Certified Risk Adjustment Coder
|Required Experience:||3 to 4 years
|Preferred Experience:||5 to 7 years
|Location:||180 5th St. East St. Paul 55101, MN, US
At HealthPartners, you’ll find a culture where we live our values of excellence, compassion, integrity and most importantly, partnership. By working together, we will improve health and well-being, create exceptional experiences for those we serve and make care and coverage more affordable.
We currently have an exciting opportunity for a Supervisor, Diagnosis Accuracy Revenue Recovery. This role is charged with supervising and providing oversight and strategic direction for the daily operational activities of the HealthPartners Care Group Revenue Recovery Analyst team. This position will work collaboratively, both internally and externally, to enhance accurate diagnosis reporting standards and processes to ensure best care/best practices. Additionally, this position will participate in Diagnosis Accuracy Team strategic discussions related to risk adjustment initiatives.
- Four-year college degree or equivalent work experience.
- Two years staff supervision and/or team project management.
- Three years demonstrated knowledge of coding.
- Registered Health Information Technician (RHIT) or Certified Professional Coder (CPC or other coding certification) and/or obtain within one year of hire.
- Demonstrated leadership and organizational skills.Ability to manage resources and staff within budget requirements.
- Ability to present information in one-on-one and group settings.
- Ability to communicate information in a professional and confident manner.
- Ability to deal with change and ambiguity.
- Demonstrated ability in critical thinking, self-initiative, and self-direction.
- An understanding of physiology, medical terminology, and disease process.
- Must understand and be able to apply Center for Medicare and Medicaid Documentation Guidelines and Third Party Payer Reimbursement Policies and Procedures.
- Demonstrated PC skills in Word, Excel, Microsoft Access, and Epic.
- Develops work plans and tools for monitoring all aspects of initiative.
- Embody the competencies of Head + Heart, Together.
- Five years working with coding systems.
- Certification as a Certified Risk Adjustment Coder
- Three years previous experience in medical record chart documentation review.
- Experience working with government programs products and risk adjustment methodologies.
- Experience working with Microsoft Project and/or similar project management technology.
- Experience working with EPIC
- Supervises Revenue Recovery Analyst(s)
- Reviews work for quality improvement purposes.
- Monitors daily staffing resources including vacation and sick time.
- Responsible for training and development of staff. As appropriate, addresses unsatisfactory performance issues.
- Responsible for hiring, training, discipline, coaching and dismissal of staff.
- Conducts annual performance reviews.
- Assists team members with daily responsibilities. Demonstrates leadership by providing daily direction and guidance for team members. Create a community of shared work and respect within the team.
- Ensures that team resources are used effectively so that customer service issues are addressed within established protocols. Ensures issues are researched and conclusions shared with appropriate individuals and documented for future reference.
- Serves as primary contact for the organization to the Revenue Recovery Analyst team. Attends management meetings as necessary and appropriate, and develops partnerships with the care group medical group and administrative leaders.
- Educates and provides feedback to physicians and other providers on diagnosis accuracy issues. Attends clinic and department staff meetings to disseminate information and to become familiar with operational issues within each business unit.
- Works with clinical site management to implement corrective action plans to improve provider documentation.
- Partners with Diagnosis Accuracy Team to develop and implement strategies to support diagnosis accuracy projects.
- Partner with care group operational coding leaders on clinical documentation and diagnosis accuracy improvement initiative including coding audits for initiative evaluation.
- Maintains current knowledge of regulations and legislation regarding billing compliance issues.
- Maintains appropriate personal certifications (e.g., coding, risk coding, and nursing).
- Provides coding education (Current Procedural Terminology (CPT), International Classification of Diseases (ICD-10 CM), and Diagnostic and Statistical Manual (DSM-5), to providers and clinical staff in accordance to the established corporate compliance plan.
- Through medical record documentation review, compiles, analyzes and presents data to clinic and medical management teams.
- With the assistance and active participation on the coding support committee, develops coding policy and procedures to present to the Documentation and Coding Steering Committee (DACSC) for care group approval.
- Develops and maintains positive working relationships with leaders and contacts with the medical group and Health Plan.
- Works independently responding to HealthPartners Care Group service issues.
- Responsible for completing work assigned by Manager/Director/Diagnosis Accuracy Team.
- Responsible for making decisions to coordinate work load and schedule of team members.
- Responsible for communication with and upholding service standards with clinics.
- Refers issues identified in the course of monitoring (compliance, policy, etc) to the appropriate Manager and Government Programs Director for decisions and resolution.
- Follows organization policies with regards to reporting of non-compliance with government programs policies and procedures.
- Performs other duties as assigned.
- Organizing team structure on daily or weekly basis to respond to HealthPartners Care Group customer service issues while maintaining continuity of contact for our providers.
- Prioritizing customer service requests according to relative importance of HealthPartners Care Group goals and customer expectations and resolving within service protocols.
- Maintaining team goals while upholding personal work expectations.
- Organizing large amounts of information, such as maintaining current knowledge in third party payer policies and current coding nomenclature and understanding contractual and operational complexities within the HealthPartners Care Group.
- Creating a sense of community and shared goals within a team structure that by nature will need to work independently on many issues.
HealthPartners is recognized nationally for providing outstanding care and experience for patients and members. We offer an excellent salary and benefits package. For more information and to apply go to www.healthpartners.com/careers and search for Job ID #50096.