Job Description:

This position is a Supervisory role and has caregivers reporting directly to them. This role will have the responsibility of advising and mentoring caregivers on the Risk Adjustment coding team and ensuring efficient workflow and quality results. They provide expert-level proficiency in the areas of Risk Adjustment Coding for highly regulated government insurance programs such as Medicare Advantage (MA), Medicaid, and the Affordable Care Act (ACA). This position performs complex reviews of clinical documentation and communicates to appropriate parties related to the results. This role creates and provides education and training to the HCC Coding Analyst team as well as other internal departments, providers and facilities as necessary regarding proper documentation, Risk Adjustment coding, policies and procedures. This position works with the Risk Adjustment Coding Manager in developing, implementing, and improving processes and procedures within the Risk Adjustment department as well as coordinating with other departments and leadership in Select Health and Intermountain Healthcare.

Job Essentials

• Leads a team that includes all levels of HCC Coding Analyst, serving as their mentor and coach. Conducts hiring, onboarding and oversees the training of all new staff on their team. Responsible for each team member’s regular assessments and professional development, as well as their timekeeping and issues related to HR.
• Provides leadership and assumes accountability for assigned team projects and processes.
• Ensures complete, accurate, consistent, and timely coding that results in compliant coding, appropriate reimbursement, and data integrity.
• Handles complex coding cases, projects or questions that require a high level of expertise or specialized coding knowledge.
• Provides support to the Risk Adjustment Coding Manager for the development, deployment and monitoring of adherence to coding policies, procedures, and standards. May supervise the development, deployment and monitoring of adherence to HIPAA policies, procedures, and standards. Assists in the safe transfer and storage of all PHI.
• Analyzes and reports on documentation and coding trends and identifies areas of concern for all approved provider types for the purpose of coding and documentation education.
• Provides content expertise in development of printed material and job aids to educate and support appropriate HCC coding procedures in the provider offices and facilities.
• Manages coding compliance reviews for HCC Coding Analysts, develops training materials to correct errors and reports results to Risk Adjustment Coding Manager
• May oversee operational functions, including chart retrieval and preparation for all retrospective and RADV audits, including chart scanning and PDF creation, and may work as the liaison between Provider Clinics, external contracted vendor staff, and the HCC Coding team in the transmission of medical records.
• Identifies opportunities to improve the delivery of medical records and addresses these with providers or clinics as assigned. May obtain, track and update the status of all EMR access for all Risk Adjustment staff. Identifies opportunities to improve the accuracy, integrity and quality of provider documentation within the medical records and addresses these with providers as assigned.
• Manages applicable government audits related to Risk Adjustment, coding and documentation.
• May provider project management and consultative services in relation to Risk Adjustment coding such as retrospective, prospective, IVA and RADV audits.
• Participates in researching and piloting new coding tools.
• Communicates clearly and effectively with all levels of the organization.
• Completes projects and tasks assigned by the Risk Adjustment Coding Manager.

Minimum Qualifications

• National Professional Coding Certification from AHIMA or AAPC
• Certified Risk Adjustment Coder (CRC) certification from AAPC
• 5 years Risk Adjustment coding experience
• 2 years of experience in a role with proven ability to be an effective coach and team builder in a leadership capacity
• Demonstrated proficiency of managing multiple priorities efficiently and effectively and coordinating workloads to meet multiple and varying deadlines
• Demonstrated sound judgment and decision-making skills and excellent verbal and written communication, presentation and analytical skills.
• Demonstrated advanced knowledge of Risk Adjustment models and diagnosis coding and the ability to learn and adapt to changes in Risk Adjustment methodology.
• Advanced level of experience with Microsoft Office applications.
• Advanced understanding of medical terminology, medical acronyms, anatomy and physiology
• Demonstrated ability to learn new concepts and applications and be able to effectively teach them to others
• Demonstrated ability to establish and maintain rapport with co-workers, physicians and other healthcare professionals

Preferred Qualifications

• Previous experience in a Supervisor or other leadership role
• RHIT Certification from AHIMA
• Experience leading a government-mandated Risk Adjustment audit
• Cross trained on all Risk Adjustment models

Physical Requirements:

Physical Requirements

• Interact with others
• Operate computers and other equipment
• Read monitors and documents
• Remain sitting or standing for long periods of time

Location:

SelectHealth - Murray

Work City:

Murray

Work State:

Utah

Scheduled Weekly Hours:

40

The hourly range for this position is listed below. Actual hourly rate dependent upon experience.

$36.22 - $57.04

We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.

Learn more about our comprehensive benefits packages for our Idaho, Nevada, and Utah based caregivers, and for our Colorado, Montana, and Kansas based caregivers; and our commitment todiversity, equity, and inclusion.

Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

All positions subject to close without notice.