Operations Supervisor, Risk Adjustment

Company: BlueCross BlueShield
Location: Chattanooga
Posted on: January 15, 2022

Job Description:

Supervise team and oversee day-to-day operations related to Medicare Advantage risk adjustment medical record retrieval, intake and coding.Job Description:BlueCross, -as a federal contractor, -may be required to implement a COVID-19 vaccine mandate.Job ResponsibilitiesDirectly supervise 1st pass review of medical records and physician assessment forms (PAFs).Perform or participate in special projects as directed by management.Oversee the acquisition of medical records from provider offices and supervise the medical record quality review process.Ensure team compliance with CMS risk adjustment diagnosis coding guidelines.Job QualificationsEducationAssociates degree in related healthcare field or equivalent years of experience. Equivalent years of experience are defined as one year of professional experience for every year of college requested.Experience2 years - Management and/or leadership experience required3 years - Progressive medical coding and health care experience required.Skills\CertificationsProfessional coding certification from AHIMA or AAPC (CPC, CCS, CRC, RHIT, RHIA).Must acquire the Certified Risk Adjustment Coder (CRC) certificate from AAPC within the first year of employment. -Ability to work independently with minimal supervision or function in a team environment sharing responsibility, roles and accountability.Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint)Proven analytical and problem solving skills and ability to perform non-routine analytical tasksMust be a team player, be organized and have the ability to handle multiple projectsExcellent oral and written communication skillsStrong interpersonal and organizational skillsKnowledge of CMS guidelines required.Understanding of ICD-10 coding standards required.Job Specific Requirements: -Preferred Skills:Number of Openings Available:1Worker Type:EmployeeWorker Sub-Type:FlexOfficeCompany:BCBST BlueCross BlueShield of Tennessee, Inc.Applying for this job indicates your acknowledgement and understanding of the following statements:BCBST is an Equal Opportunity employer (EEO), and all employees and applicants will be entitled to equal employment opportunities when employment decisions are made. BCBST will take affirmative action to recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law.Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page:BCBST's EEO Policies/NoticesBlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means. All applicants will -be advised that BlueCross, -as a federal contractor, -may be required to implement a COVID-19 vaccine mandate.Tobacco-Free Hiring StatementTo further our mission of peace of mind through better health, effective 2017, BlueCross BlueShield of Tennessee and its subsidiaries no longer hire individuals who use tobacco or nicotine products (including but not limited to cigarettes, cigars, pipe tobacco, snuff, chewing tobacco, gum, patch, lozenges and electronic or smokeless cigarettes) in any form in Tennessee and where state law permits. A tobacco or nicotine free hiring practice is part of an effort to combat serious diseases, as well as to promote health and wellness for our employees and our community. All offers of employment will be contingent upon passing a background check which includes an illegal drug and tobacco/nicotine test. - An individual whose post offer screening result is positive for illegal drugs or tobacco/nicotine -and/or whose background check is verified to be unsatisfactory, will be disqualified from employment, the job offer will be withdrawn, and they may be disqualified from applying for employment for six (6) months from the date of the post offer screening results. Resources to help individuals discontinue the use of tobacco/nicotine products include smokefree.gov or 1-800-QUIT-NOW.Full time

Keywords: BlueCross BlueShield, Chattanooga , Operations Supervisor, Risk Adjustment, Other , Chattanooga, Tennessee