Supervisor Risk Adjustment and Quality Assurance - Houston, United States - KS Management Services, LLC

Mark Lane

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Mark Lane

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Description

Responsibilities
Assist with development, implementation, and oversight of team projects. Assist with development of HCC coding team by providing education, answering questions, troubleshooting problems, and assisting with code/diagnosis research.

Ensure the accurate coding of diagnoses which fall into the HCC model as required by CMS for Medicare Advantage plans.

Ensure documentation of diagnoses meets the requirements set forth by CMS and the Official ICD-10-CM Guidelines for Coding and Reporting


Job Title:
Supervisor Risk Adjustment Quality Assurance


Location:
Pearland Administrative Office


Department:
KS Plan Advantage-Risk Adjustm**
Job Type: Full Time

Salary Range:
$

90,932 - $112,318 (Pay is based on several factors including but not limited to education, work experience, certifications, etc.)

Qualifications

Education

Required:
Associates degree or equivalent experience


Preferred:
Bachelor's degree in health related field


Experience

Required:
Requires 2-3 years Internal, or 4-5 years external, experience in HCC specific coding/auditing.

Requires experience in a broad range of HCC related audit types and/or projects.

Experience auditing physicians and coders. Experience in physician documentation/coding education.

Experience in educating/training coders. ICD-10-CM Coding knowledge. Proof of 10+ hours ICD-10-CM training

or AAPC ICD-10-CM Assessment certificate.


Preferred:
Experience with leading, coordinating, or supervising an HCC coding team


License(s)

Required:
Either CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist-Physician), and CRC

(Certified Risk Adjustment Coder)


Preferred:
CPMA (Certified Professional Medical Auditor, CDEO (Certified Documentation Expert Outpatient),

Clinical Licensure such as RN, LVN, RHIT


Special Skills

Required:
Thorough understanding of Risk Adjustment, HCC coding, ICD coding, and RADV requirements.

Knowledge of Medicare Advantage and other HCC entity program coding requirements. Team building skills.

Proficient in Word, Excel and Outlook.


Preferred:
Experience with EPIC EMR. HEDIS experience helpful


Other

Required:
Excellent communication, presentation, and analytical skills.

Demonstrated problem solving, written and verbal skills. Able to work with people of various educational,

cultural and socioeconomic backgrounds.

Requires ability to travel locally in your personal vehicle.


Preferred:

Working Environment:
Office


About Us
Start your career journey and become a part of a community of renowned Healthcare professionals. Kelsey-Seybold Clinic is Houston's fastest growing, multispecialty organization with more than 40 premier locations and over 65 specialties.

Our clinics are comprised of more than 600 physicians and as we continue to grow, our focus is providing quality patient care by adding to our team of clinical and non-clinical professionals that work together in a convenient, coordinated, and collaborative manner.

Enjoy the rewards of a successful career while maintaining a work/life balance by joining our team today and changing the way health cares.


Why Kelsey-Seybold Clinic?

  • Medical, Vision, and Dental
  • Tuition Reimbursement
  • Company Matching 401K
  • Employee Reward and Recognition Program
  • Paid time off for vacation, sick, and holidays
  • Employee Assistance Program
  • Continuing Medical Education allowance

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