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Supervise the daily operations and work flow of the Medical Coding Specialists ensuring that 100% of the retrieved charts are coded. Provide guidance to the RAPS Medical Coding specialists to ensure proper ICD-9 coding and CMS compliance.
The Supervisor, Medical Coding Specialists (S-MCS) supervises the daily operations and work flow of the Medical Coding Specialist (MCS) Team;
The S-MCS provides guidance and motivation to the MCS Team in their day to day job functions, actively mentoring and providing training as needed;
He/she ensures coding productivity and quality goals and objectives are consistently met;
The S-MCS provides ongoing training and continuing education to the Medical Coding Specialists regarding risk adjustment, proper ICD-9 coding, and ICD-10 coding through written materials, conference calls, Webinars, or presentations;
He/she serves on the RADV committee as a subject matter expert;
The S-MCS coordinates yearly continuing education unit (CEU) coder training seminars;
He/she conducts staff meetings on a weekly basis - instilling a team approach, focused on meeting productivity goals and compliance metrics;
The S-MCS works closely with the Mgr, Medical Coder Auditing to ensure that the MCS Team's coding is meeting and/or exceeding QA standards. Upon approval of the Director, Risk Adjustment, the S-MCS and the M-MCA will develop, implement, evaluate and improve coding policies and procedures and departmental operations as needed;
He/she serves as the MCA business representative for system enhancements (e.g. data entry tool design);
The S-MCS is accountable for understanding the intricacies of the ICD-9 coding guidelines and its application to risk adjustment coding;
An important function of the S-MCS is to prepare and submit to the Director, Risk Adjustment weekly productivity reports including key performance metrics and quarterly productivity trending reports. The S-MCS is responsible for researching industry best practices for productivity-enhancement processes, for understanding the financial impact of productivity, data capture and reporting tools, processes and systems to present to the Director, Risk Adjustment on a quarterly basis;
The S-MCS and the M-MCA develop mutually agreed upon corrective action plans, training sessions, and re-training programs to ensure that the QA standards are consistently met;
He/she ensures compliance with all applicable federal, state and local regulations, as well as with institutional/organizational standards, practices, policies and procedures;
The S-MCS assists in other projects as necessary.
The S-MCS reviews members' medical records from primary and specialist care providers to identify all ICD-9's that meet CMS and ICD-9 coding guidelines. Complete data entry for identified ICD-9's
The S-MCS is responsible for hiring, promoting, establishing PIP, establishing goals and objectives, conducting performance appraisals, approving time, and establishing P&P for the MCS.
Required - Bachelor's Degree in a related field
Required - 5 years of experience in professional coding either in a hospital or physician setting
Required - 3 years of experience in managed care with knowledge of RAPS
Required - 3 years supervisory experience
Ability to work in a fast paced environment with changing priorities
Demonstrated customer service skills
Ability to lead/manage others
Knowledge of medical terminology and/or experience with CPT and ICD-9 coding
Demonstrated interpersonal/verbal communication skills
Demonstrated written communication skills
Licenses and Certifications:
Required Certified Professional Coder (CPC)
Required - Intermediate proficiency working with Microsoft Outlook, Word, Excel, Visio, and Power Point