Supervisor Risk Adjustment Chart Retrieval - Capital Blue Cross
Harrisburg, PA 17177
About the Job
Base pay is influenced by several factors including a candidate’s qualifications, relevant experience, and anticipated contributions to meet the needs of the business, along with internal pay equity and external market driven rates. The salary range displayed has not been adjusted for geographical location. This range has been created in good faith based on information known to Capital Blue Cross at the time of posting and may be modified in the future. Capital Blue Cross offers a comprehensive benefits packaging including Medical, Dental & Vision coverage, a Retirement Plan, generous time off including Paid Time Off, Holidays, and Volunteer time off, an Incentive Plan, Tuition Reimbursement, and more.
At Capital Blue Cross, we promise to go the extra mile for our team and our community. This promise is at the heart of our culture, and it’s why our employees consistently vote us one of the “Best Places to Work in PA.”
The Risk Adjustment Charts Retrieval Supervisor is responsible to oversight Capital’s Risk Adjustment chart retrieval and indexing operations and daily activities of the internal team and vendors ensuring compliance with documentation guidelines, regulatory standards, and policies and procedures. This role ensure compliance with state, federal, and medical record guidelines, while maintaining the integrity of paper chart storage and retention. This role is also lead and support the team to meet production and quality standards to meet Risk Adjustment projects timeline and goals. This position services Medicare and Commercial/ACA Risk Adjustment Programs and reports to the Risk Adjustment Program Director.
- Supervises, monitor and mentor daily quality, productivity, and training of Risk Adjustment medical records/charts retrieval team.
- Provide guidance and support to the Risk Adjustment medical records/chart retrieval team through discussion of complex cases, answering questions, and establishing feedback loop. Function ad subject matter expert and provide guidance analyzing medical records content, determine appropriate disposition, etc.
- Responsible of the daily delegation and assignments of medical records/chart retrieval and indexing to the risk adjustment chart retrieval specialists ensuring appropriate management of the inventory based on project timelines.
- Creates and/or maintains chart retrieval specialists’ performance tracking system to measure and monitor accuracy and production goals.
- Develop educational materials or trainings for the team based on documentation and/or compliance guidelines, quality assurance audits results, etc. Identifies any errors or deficiencies in retrieval or indexing practices and makes improvements through staff training and/or enhancements in processes.
- Support the development and/or maintain up to date appropriate workflows, policies and procedures, and medical records/chart retrieval team materials.
- Participates in CMS audits of Risk Adjustment activities, including but not limited to Risk Adjustment Data Validation audits.
- Participates in new employee selection, lead on-boarding processes, and performs talent managements for the Risk Adjustment Chart Retrieval team.
- Perform any other job duties as requested.
Skills:
- Excellent verbal communication and interpersonal skills. Able to convey complex information in a manner that others can understand. Proven success on building and maintaining positive relationships. Exemplary of a highly collaborative team approach. Ability to influence and persuade people to collaborate and execute toward a common goal.
- Strong organization and documentation, attention to details, ability to handle multiple projects tasks simultaneously, time management meeting deadlines, even under pressure.
- Successful record of managing multiple projects tasks with excellent results, meeting desired outcomes and goals. Eager to work with sense of urgency aligned with priorities, overcome obstacles, if needed seek for support early driving the best results to positive impact the Company and team goals.
- Ability to think analytically to resolve issues; solution-focused mindset; creative, innovative, and compliance thinker. Comfortable to bring and implement new ideas for process improvement.
- Adaptability to an agile and dynamic work environment with a strong skills of time management and task prioritization.
- Strong proficiency in Microsoft Office applications (Outlook, Word, Excel, Power Point, etc.), Teams/WebEx/ZOOM, Power BI.
- Detail and quality oriented as it relates to accurate and compliant information for medical records.
- Advanced skills managing and supervising operations/production environments.
- Knowledge of ICD-10-CM coding guidelines, medical terminology, and clinical practice and processes.
- Strong ability to coordinate/lead/execute medical records retrieval initiatives, and projects tasks in a fast speed and changing environment.
Knowledge:
- 3 years of Health Information management experience.
- 1 Medicare and Commercial/ACA Risk Adjustment experience.
- Supervisor or team leadership experience in a production/metric-based, operations, service-related area preferred.
- 2 years’ experience working with Medicare Advantage Plans experience.
- 2 years of experience conducting medical records retrieval and/or review process (paper medical records and/or common EMR systems e.g., Allscripts, EPIC, AthenaHealth, PracticeFusion, and Medent).
Experience:
- Highschool diploma or equivalent required.
- Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), or Certified Coding Specialist (CCS) preferred.
- Medical Record Technology/Administration Program or equivalent coursework preferred.
Location:
This position is classified hybrid, which requires onsite work on Tuesdays and Wednesdays in Harrisburg, PA.
Travel:
- 25% driving to provider offices and/or work from the office.
Physical Demands:
- While performing the duties of the job, the employee is frequently required to sit, use hands and fingers, talk, hear, and see.
- The employee must be able to work over 40 hours per week.
- The employee must occasionally lift and/or move up to 5 pounds.