Operations Supervisor, Risk Adjustment

Job not on LinkedIn

5 hours ago

🎸 Tennessee – Remote

Although this job is listed in Tennessee, this company may be open to hiring remote in other states.

⏰ Full Time

🟡 Mid-level

🟠 Senior

🎲 Risk

🦅 H1B Visa Sponsor

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BlueCross BlueShield of Tennessee

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Healthcare Insurance

BlueCross BlueShield of Tennessee is a leading health plan provider in Tennessee, serving 3. 4 million members. The company is committed to creating a workforce where everyone is valued, respected, and part of the team, emphasizing diversity and inclusion. They offer a range of career opportunities, including internships through their BlueBridge program, enabling new professionals to transition from college to work. BlueCross BlueShield of Tennessee also focuses on providing exceptional customer service and community care, striving to make a difference in the healthcare industry. It is an independent licensee of the Blue Cross Blue Shield Association and a qualified health plan issuer in the Health Insurance Marketplace.

5001 - 10000 employees

Founded 1952

⚕️ Healthcare Insurance

📋 Description

• Assign and monitor coding and QA tasks, ensuring production and quality goals are achieved. • Provide feedback, coaching, and support to team members. • Manage day-to-day operations, including PTO approvals and resolving workflow challenges. • Act as the go-to resource for troubleshooting issues, whether technical or process-related. • Directly 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.

🎯 Requirements

• Associates degree in related healthcare field or equivalent years of experience • 2 years - Management and/or leadership experience required • 3 years - Progressive medical coding and health care experience required • Professional 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 tasks • Knowledge of CMS guidelines required. • Understanding of ICD-10 coding standards required.

🏖️ Benefits

• Health insurance • Retirement plans • Paid time off • Flexible work arrangements • Professional development opportunities