Supervisor Risk Adjustment Chart Retrieval - Capital Blue Cross

Position Description:Responsibilities and Qualifications:

• 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.

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.

About Us:We recognize that work is a part of life, not separate from it, and foster a flexible environment where your health and wellbeing are prioritized. At Capital you will work alongside a diverse and caring team of supportive colleagues and be encouraged to volunteer in your community.  We value your professional and personal growth by investing heavily in training and continuing education, so you have the tools to do your best as you develop your career.     And by doing your best, you’ll help us live our mission of improving the health and well-being of our members and the communities in which they live.