Job Information
CDPHP Supervisor, Risk Adjustment Coding Operations in Albany, New York
Grounded by a compelling mission, core values, and compassion for people, CDPHP and its family of companies offer a strong foundation for a rewarding career. Established in 1984, CDPHP is a physician-founded, member-focused, and community-based not-for-profit health plan that offers high-quality affordable health insurance to members throughout New York. The company values people, quality, innovation, and community, and its corporate culture supports those values wholeheartedly. CDPHP is committed to fostering a culture of belonging and takes a wholistic approach to diversity, equity, and inclusion. At CDPHP, the employees have a voice and are encouraged to make an impact at both the company and community levels through engagement and volunteer opportunities. CDPHP invests in employees who share these values and invites you to be a part of that experience.
Annual salary range: $75,000 - 95,000
The Risk Adjustment Coding Supervisor will be responsible for oversight of CDPHP’s Risk Adjustment Coding Specialists. This includes monitoring, tracking and reporting on individual and team coding quality and productivity, addressing quality, productivity and other staff concerns, and developing strategies to enhance efficiency and quality practices. This position will work with the Manager, Risk Adjustment Coding Operations to prioritize coder workflows, communicate risk adjustment coding changes to staff, assist with review of complex coding inquires, and other personnel management tasks. This position will also assist the team in conducting chart review coding as needed.
QUALIFICATIONS:
Associate's degree or two (2) years of equivalen experience required.
CCS (Certified Coding Specialist) or CPC (Certified Coding Professional) credential required.
Certified Outpatient Coder (COC), Certified Inpatient Coder (CIC), or Certified Professional Coder Payer (CPC-P), will be considered with successful completion of CPC or CCS certification within one year of employment.
CRC (Certified Risk Adjustment Coder) credential preferred.
Minimum three (3) years in an HMO, Managed Care Organization or in a health care setting is required.
Minimum two (2) years in a coding supervisory role, or other project management, team lead, or senior level related experience required.
Knowledge of ICD-9 / ICD-10 diagnosis and procedure codes, CPT codes, Revenue codes, and HCPCS codes is required.
Strong knowledge of medical terminology, anatomy and physiology, and medical record/chart review experience required.
Provider office relations and communication experience strongly preferred.
Hierarchical Condition Category (HCC) knowledge preferred.
Diagnosis code auditing experience is preferred.
Experience in claims adjudication, billing and enrollment systems, product or pricing is preferred.
Experience with Microsoft Office, including Word, Excel, Outlook and PowerPoint is required.
Demonstrated ability to meet or exceed productivity and quality standards.
Strong research and policy review and development skills.
Demonstrated ability to lead, coach, train or supervise staff.
Demonstrated ability to work collaboratively with multiple partners to positively affect outcomes at the team, organization and member level.
Must be detail-oriented with strong organizational skills, including the ability to coordinate workflow.
Demonstrated ability to pro-actively identify problems, as well as recommend and/or implement effective solutions.
Demonstrated ability to participate in project/initiatives that are code or code auditing related.
Demonstrated ability to work with and maintain confidential information.
Excellent verbal and written communication skills.
Flexibility to adapt to a changing and fast-paced environment.
CDPHP salary ranges are designed to be competitive with room for professional and financial growth. Individual compensation is based on several factors unique to each candidate, such as work experience, qualifications, and skills. In addition to cash compensation, CDPHP employees may be eligible for an incentive payment, a discretionary cash reward based on employee and company performance. Some roles may also be eligible for overtime pay.
CDPHP compensation packages go far beyond just salary. The company offers a comprehensive total rewards package that includes award-winning health care coverage, health care dollars, a generous paid time off allowance, employee assistance programs, flexible work environment, and much more. Learn about all CDPHP employee benefits at https://www.cdphp.com/about-us/jobs/benefits.
As an Equal Opportunity / Affirmative Action Employer, CDPHP will not discriminate in its employment practices on the basis of race, color, creed, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship, disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, protected veterans status, or any other characteristics protected under applicable law. To that end, all qualified applicants will receive consideration for employment without regard to any such protected status.
CDPHP and its family of companies include subsidiaries Strategic Solutions Management Consultants (SSMC), Practice Support Services (PSS), and ConnectRx Services, LLC.