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Supervisor National HCC Services Job in Berkeley Heights, New Jersey

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Job Title: Supervisor National HCC Services

Employer:Summit Medical Group
Skills:Candidate should be able to create/maintain comprehensive tracking and management tools for providers
Required Certifications:CPC,CRC,RHIT or RHIA,CCS-P,CCA
Preferred Certifications:CCP-P,CPPM,CPCO,CPMA,CHC,CEME
Required Experience:3 to 4 years
Location:1 Diamond Hill Rd Berkeley Heights 07922, NJ, US
Date Posted:8/30/2018

Supervisor National HCC Services

Coding Compliance Department * Berkeley Heights, NJ


At Summit Health Management (SHM), our goal is to positively impact the quality and availability of health care across the country while ensuring the continued vitality of patient-centric, physician-owned and governed medical groups. Established in 2014 by the physician owners of Summit Medical Group (SMG), one of the largest and most highly regarded independent multispecialty medical groups in the nation, SHM drives performance enhancements for its partners by providing expertise in organizational structure and governance, operations, revenue cycle management, physician management, population health management and other administrative and clinical functions.


Working closely with the HCC Team Lead, you will provide leadership and support for the daily operations of the HCC Team, identify and implement documentation improvement strategies, and oversee charts as well as the preparation of reports for management on audit findings. In addition, you will serve as a liaison between management and staff, and provide support to management on a variety of special HCC projects.


Responsibilities include:


·         Planning, organizing and coordinating the daily operations for the HCC team

·         Developing and implementing workflows on identified advancements/enhancements in the department

·         Training, educating and cross training staff

·         Monitoring and ensuring projects are kept on track

·         Ensuring accurate and appropriate documentation through oversight of chart audits

·         Overseeing and performing audit reviews for risk assessment purposes, as well as internal/external audits to monitor compliance to final resolution

·         Ensuring documentation meets requirements for diagnosis assignment, based on official ICD10 and HCC guidelines

·         Conducting audit reviews related to Coding Compliance initiatives

·         Communicating and meeting regularly with Providers and SMG staff regarding HCC coding changes and compliance issues

·         Assisting in the creation of individual provider education plans

·         Developing National Account, HCC approach and workflows

·         Tracking audit findings including all documentation errors; medical record errors; diagnosis errors and missed HCC opportunities in department database

·         Identifying audit trends, risk areas, and suspect conditions based on audit findings and data analysis

·         Working with project managers to implement an agreed strategy for identified projects

·         Handling other related functions as necessary


Successful candidate will have a Bachelors Degree supported by 3 years of coding compliance experience that includes at least 2 years’ experience with HCC/Risk Adjust Model auditing. Medical Coding Certificate, Coding Certifications (CRC, CPC, CCS-P, CCA, RHIT or RHIA), and an understanding of coding concepts, AMA, CMS/OIG/Federal/State regulations/guidelines, HCC and other risk adjustment reporting models and measurements are all essential. Candidate should also be able to create/maintain comprehensive tracking and management tools for providers for the HCC process, work to develop organizational goals, audit and/or abstract code medical record for proper assignment of diagnoses, and educate/train physicians, providers and other staff regarding HCC coding concepts and documentation. Solid leadership, decision-making, analytical, oral/written communication and PC (Word, Excel, PowerPoint) skills. Auditing, compliance, billing or practice management certifications (CEMC, CPCO, CPMA, CCP-P, CHC, CPPM, etc.) preferred.


We offer a competitive salary, comprehensive benefits package, and a dynamic working

environment. For immediate consideration apply online at:




Summit Health Management



We are a smoke and drug-free environment. EOE M/F/D/V



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