Medical Coding Auditor Supervisor-1

Profile

Description

The Medical Coding Auditor Supervisor handles a combination of tasks, including extracting clinical information from a variety of medical records and assigning appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding Auditor Supervisor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. In addition to completing the functions of an auditor, the Medical Coding Auditor Supervisor is also responsible for directly managing a team of medical coding auditors and handling the day-to-day tasks associated with leading a team (payroll, evaluating performance, etc.).

Responsibilities

Essential Functions

Directly supervises a team of Medical Coding Auditors

Assists the Audit Manager with data analysis, team management, goal setting, and other projects as assigned

Completes audits for assigned providers and/or coders:

Verifies and ensures the accuracy, completeness, specificity, and appropriateness of medical record documentation based on a patient's documented medical conditions

Confirms appropriate diagnosis and procedure code assignment, in accordance with all applicable coding guidelines

Utilizes electronic tools (i.e., spreadsheets) that have been created based on the CMS-HCC model and established coding guidelines

Prepares written summaries of audit findings

Presents verbal audit feedback and provides education upon completion of the medical record audit

Responds to or clarifies internal requests for information

Supports and participates in process and quality improvement initiatives

Partners with business associates from other departments to understand their needs and concerns, and participate in the development of system solutions

Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas

Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed.

Follows established guidelines/procedures

Assists in other coding capacities as needed

Required Qualifications

CPC, CCS, or CCS-P AND CPMA AND CRC

Physician office coding experience, preferably in a risk adjustment setting

Passionate about contributing to an organization focused on continuous improvement

Proficient verbal and written communication skills

Data analysis

Proficient in all Microsoft Office applications, including Word and Excel

Public speaking / group presentation skills

Ability to travel locally and overnight within all the Care Delivery Organization's markets (Florida, Carolinas, Texas, Nevada, Kansas, etc.)

Preferred Qualification

CDEO

Bachelor's Degree

Physician office auditing experience, preferably in a risk adjustment setting

Other Notes

This is a WAH position

May require travel within the assigned market or to corporate offices within the Care Delivery Organization's markets (Florida, Carolinas, Texas, Nevada, Kansas, etc.)

Preferred Qualifications

Additional Information

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com