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:
https://jobs.summithealthmanagement.com/job/warren-township/supervisor-national-hcc-services/1769/8400106
Summit Health Management
https://jobs.summithealthmanagement.com/
We are a smoke and drug-free environment. EOE M/F/D/V