Clinical Coding and Risk Adjustment Director
1 week ago
About Optima Medical:
We are an Arizona-based medical group with 23 locations and over 90 medical providers, serving more than 120,000 patients statewide. Our mission is to enhance the quality of life in Arizona by delivering personalized healthcare, focusing on preventing leading causes of death. We offer a comprehensive range of services, including cardiovascular health, behavioral health, allergy testing, lab testing, imaging, chronic disease management, and specialty health services.
Career Summary:
We are seeking an experienced Coding Manager – Risk Management to lead our risk adjustment coding operations. As a key member of our team, you will manage coders, ensure compliance with documentation and coding standards, and drive initiatives to optimize coding accuracy and value-based care performance. You will play a critical role in aligning our coding practices with our mission to deliver high-quality, cost-effective care.
Key Responsibilities:- Team Leadership: Manage and supervise a team of risk adjustment coders, providing guidance, mentorship, and performance evaluations.
- Coding Process Oversight: Ensure accurate, compliant, and aligned coding processes with CMS and regulatory guidelines.
- Quality Assurance: Implement programs to monitor and improve coding accuracy and documentation practices.
- Collaboration: Work with providers and care teams to identify documentation improvement opportunities and support education initiatives.
- Data Analysis: Analyze coding and risk adjustment data to identify trends, gaps, and opportunities for optimizing value-based care performance.
- Process Improvement: Lead initiatives to enhance efficiency, productivity, and compliance in coding operations.
- Industry Expertise: Stay current with ICD-10-CM codes, CMS regulations, and industry best practices to ensure organizational compliance.
- Reporting: Prepare reports on coding accuracy, productivity, and risk adjustment performance for leadership and stakeholders.
- Experience: Minimum of 3 years in risk adjustment coding, with at least 1 year in a leadership or supervisory role.
- Certification: Active coding certification through AAPC or AHIMA (e.g., CPC, CRC).
- Expertise: Proven expertise in ICD-10-CM coding, CMS documentation requirements, and value-based care principles.
- Leadership Skills: Strong leadership and team management skills, including mentoring and performance management.
- Education: Bachelor's degree in a related field (preferred) or equivalent experience.
- Technical Skills: Proficiency in Microsoft Outlook, Word, and Excel, with experience in EHR and coding platforms.
- Communication Skills: Excellent analytical, written, and verbal communication skills.
- Priority Management: Ability to manage multiple priorities in a fast-paced environment while maintaining high levels of accuracy and productivity.
- Leadership Opportunities: Take charge of a team and make a significant impact on organizational outcomes.
- Career Development: Enjoy growth opportunities in a dynamic, expanding organization.
- Engaging Culture: Participate in team events, happy hours, and holiday celebrations.
- Comprehensive Benefits: Medical, vision, dental, 401(k), and paid holidays.
- Supportive Environment: Work with a collaborative and forward-thinking leadership team.
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