Lead, Provider Risk Adjustment (RN required)

CorroHealth; United States; Remote; USD 70,000 - 90,000; Full time

Job summary

A leading company in the healthcare revenue cycle is seeking a Lead, Provider Risk Adjustment to oversee coding services. The role involves managing a team, ensuring coding quality, and collaborating with clients. Ideal candidates will have an RN or LPN license, coding certifications, and strong communication skills. This is a remote, full-time position with opportunities for professional growth.

Qualifications

• At least 3+ years of previous provider-based risk adjustment coding experience.
• Previous supervisory experience is preferred.

Responsibilities

• Lead, Provider Risk Adjustment Coding Services.
• Supervise a team of Client Account Coders.
• Monitor client reports and resolve issues as necessary.

Skills

Communication

Attention to Detail

Initiative

Education

RN or LPN license

National certification through AAPC or AHIMA

Tools

Microsoft Office

Job description

Lead, Provider Risk Adjustment (RN required) page is loaded

Lead, Provider Risk Adjustment (RN required)

Apply locations US - Remote time type Full time posted on Posted 4 Days Ago job requisition id JR102489

About Us:

Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals.

We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success.

JOB SUMMARY:

ESSENTIAL DUTIES AND RESPONSIBILITIES:
Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.

Lead, Provider Risk Adjustment Coding Services

As a member of the CorroHealth team, the Coding Lead utilizes coding knowledge to assist the Director of Coding Services and other members of the Management team in maintaining a high level of client satisfaction through managing the overall quantity and quality of coding production for assigned clients. The candidate will supervise a team of Client Account Coders.

Essential Functions:

Note: The essential duties and primary accountabilities below are intended to describe the general content of and requirements of this position and are not intended to be an exhaustive statement of duties. Incumbents may perform all or most of the primary accountabilities listed below. Specific tasks, responsibilities or competencies may be documented in the incumbent’s performance objectives as outlined by the incumbent’s immediate supervisor or manager.

• Collaborators with global leaders on daily production quantity and quality for each assigned client while maintaining client service level agreement metrics and delivery expectations
• Review pending accounts and second level quality reviews and for errors or assigns to appropriate staff for remediation and completion
• Monitors client reports – production, quality, query compliance, and response and resolves issues as necessary
• Assists in research and resolution of QA disputes and education/trends
• Tests system and workflow changes related to specific client hospitals
• Assist assigned Coding Director with independent responsibilities for client reporting and data analysis
• Recommended staffing modifications and FTEs, assist in overtime planning when necessary
• Recommend and process salary changes/adjustments/promotions as necessary
• Responsible for training assistance of new and existing HCC Coding Specialists
• Participate in and/or lead special projects requiring coding and/or auditing for clients across the organization, as needed
• Develops and communicates coder schedule and resolves changes to schedule
• Assist direct reports with accurate application of diagnosis and procedure codes utilizing CMS/HHS HCC models, ICD-10-CM, ICD-10-PCS, CPT, and HCPCS
• Provide and/or aid direct reports with interpretation of coding guidelines for accurate code assignment
• Identify and ensure that direct reports understand the importance of documentation on code assignment and the subsequent reimbursement impact
• Align personal conduct with and build a team culture that aligns conduct with AHIMA's Standards of Ethical Coding and the Company’s Code of Ethics and Business Conduct
• Comply with, promote and support direct report’s compliance with all internal policies and procedures
• Actively participate in Company provided training and education and ensure that direct reports complete mandatory training and education by established deadlines and are able to properly implement and/or practice the principles taught via the Company’s training and education program
• Ensure individual and direct report compliance with all privacy and security rules and regulations and commit to the protection of all Company confidential information, including but not limited to, Personal Health Information
• Thoughtfully evaluate risk, participate in the development of risk mitigation activities and engage in correcting deficiencies

Knowledge, Skills & Abilities:

• RN or LPN license required
• National certification through AAPC or AHIMA required, CCDS or CDIP a plus
• At least 3+ years of previous provider-based risk adjustment coding experience with strong understanding of physician query compliance and composition
• Previous supervisory experience is preferred
• Strong computer skills, proficient in Microsoft Office applications including Word and Excel.
• Ability to navigate in a variety of EMR environments and review hand-written charts
• Strong verbal and written communication skills are required
• Ability to prioritize workload, to meet deadlines and to maintain a high level of quality and accuracy
• Initiative, resourcefulness, and attention to detail
• Regular, predictable, and punctual attendance is required

PHYSICAL DEMANDS:
Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines.
A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

Similar Jobs (2)

Lead, Provider Risk Adjustment

locations US - Remote time type Full time posted on Posted 4 Days Ago

Director, Coding Solutions (Risk Adjustment)

locations US - Remote time type Full time posted on Posted 2 Days Ago

CorroHealth sits at the center of the revenue cycle revolution. Fundamental operations of the revenue cycle are supported through our expert teams while we recast the role of clinicians through automation. This shift to a true clinical revenue cycle helps us achieve our core purpose – exceed client financial health goals.

For each patient population, CorroHealth automates key clinical aspects of the cycle. Our platforms focus on capture and application of clinical documentation while easing the burden on physicians.

Scalability is prioritized in the support of client program operations. As with most revenue cycle partners, our skilled and enthusiastic team is available to outsource any portion of the cycle. However, we can also complement client programs with additional expert support or upskill existing client teams to meet program demands.

Whether our team is deployed directly, or automation is incorporated for a more programmatic solution, CorroHealth delivers.

Applicants will only receive job-related emails from the domain @corrohealth.com.

Additionally, it is important to emphasize that CorroHealth will never ask for money in return for a job offer.