Risk Adjustment Supervisor

Summary

The Supervisor of Risk Adjustment (RA) Auditing and Coding reports to the Risk Adjustment

Manager. S / he performs duties to conduct the day-to-day operations of the Risk team functions

by communicating with other operational departments and Provider Offices. S / he will

participate in the development, implementation and performance of workflows for auditing

electronic medical records aimed at improving the health and well-being of patients and proper

identification of Chronic Disease Conditions as well as working to create a unique data and

reporting model to capture and optimize ICD10 reporting to Payers to improve quality for our

patients and reduce healthcare costs for our clients.

Essential Duties and Responsibilities i nclude the following. Other duties may be assigned.

• Ensure compliance with all applicable Federal, State and / or County laws and regulations

related to coding and documentation guidelines for Risk Adjustment.

progress notes, consultation reports, diagnostic reports, operative and pathology reports,

and discharge summaries in order to verify whether :

Guidelines for Coding and Reporting.

submitted within the permitted timeframe.

to the carrier within timely guidelines to ensure on supported codes remain on record

with those carriers.

patient.

Services for use in provider / staff training sessions.

on the project and its goals.

Human Resources Job Description : (Risk Adjustment Supervisor) Rev. 2 / 11 / 2021

to all patients, providers, internal and external customers.

reporting systems or data base, suggests performance improvement opportunities and

tracks through completion to insure revenue capture.

which may include travel as well as hours outside of standard business hours and / or

above 40 hours per week.

existing staff along with regularly performing quality reviews and including feedback on

opportunities for improvement to the Risk Coding team.

Supervisory Responsibilities

Directly supervises assigned employees in the Risk department. Carries out supervisory

responsibilities in accordance with the organization's policies and applicable laws.

Responsibilities include interviewing, hiring, and training employees; planning, assigning, and

directing work; appraising performance; rewarding and disciplining employees; addressing

complaints and resolving problems.

Education and / or Experience

Bachelor's degree from four-year college or university; or two - three years related experience

and / or training; or equivalent combination of education and experience. Must have one of the

following : CPC, CRC, RHIT or similar. Position requires flexibility in work hours, multitasking, and excellent computer skills.

Job Posted by ApplicantPro