At ClareMedica, exceptional is the standard.
Driven by our purpose to enhance the lives of the seniors in the communities where we have the privilege to work, live, and play, the ClareMedica team is comprised of the brightest and best in their fields of expertise. From clinical excellence to unparalleled administrative support and beyond, we’re working together to help seniors live happier, healthier, fuller lives.
That kind of teamwork and passion for excelling can only exist in a workplace that fosters employees’ growth and wellness and where their full potential and value are realized. At ClareMedica, we’re excited about great people like you. We’re even more excited to support you with the resources, training, benefits, competitive compensation, and more to help you thrive and succeed in our communities.
Opportunity awaits – welcome to ClareMedica.
ESSENTIAL FUNCTIONS
The Medical Coding Supervisor position is a key corporate functional role for the organization that will oversee the daily operations and delivery of coding and coding compliance services. This individual is responsible for analyzing member information to ensure the Risk Adjustment Factor accurately reflects the membership health profile. They also develop and implement processes and procedures to ensure the accuracy and completeness of the risk adjustment program and to ensure compliance with all CMS and State regulations and guidelines (as applicable). Other responsibilities include overseeing, coordinating, and evaluating the performance of the risk adjustment program and refining annual risk adjustment program strategies to achieve optimal performance.
DUTIES AND RESPONSIBILITIES
• Hire, train, manage, and evaluate coding team.
• Staff supervision of quality assurance, scheduling, monitoring workflow, and preparing productivity reports.
• Promotes the steady workflow of coding and performs coding quality reviews to improve coding accuracy.
• Ensure compliance and provide education to the internal coding team, vendors, and providers.
• Minimize payor denials for all diagnostic and procedural codes assigned to medical records for the collection and indexing of quality health information.
• Reviews submitted medical records to identify ICD-10-CM diagnoses; codes all diagnoses and services accurately and completely.
• Supports coordination with customers, internal coding team and vendors on coding guidelines and chart reviews.
SUPERVISORY RESPONSIBILITIES
This position has supervisory responsibilities.