Job Title: Team Lead – Payor (Risk Adjustment coding/HCC)
Department: Production
Reports To: Manager – Payor
Employment Type: Full-time, Mon through Fri, with occasional evening or weekend availability as required for project deadlines.
Eligibility: Minimum of 6 years’ experience in risk adjustment coding and should have been a team lead on paper for 1-2 year.
Job Overview: We are seeking a highly motivated and experienced Team Lead – Payor (Risk Adjustment coding/HCC) to manage our risk adjustment coding team. The ideal candidate should be an AAPC/AHIMA certified seasoned operations leader who will be responsible for production and quality of a span of 30-40 coders. This role requires a deep understanding of HCC coding practices and US healthcare regulations.
What is expected:
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Responsible for team’s production and quality.
- Need to conduct weekly and monthly quality review meetings with coders.
- Present monthly ROB on team’s performance.
- Publish weekly performance report (production and quality) post review.
- Should be able to deliver the base production target is achieved.
- Monitor head count and control attrition.
- Communicate quality standards and expectations to all stakeholders to ensure transparency and accountability.
- Identify potential risks in the coding process impacting outgoing quality and develop strategies to mitigate them.
- Monitor and track key performance indicators (KPIs) related to coding accuracy and compliance.
- Monitor and make sure the audits, feedback mechanism and education process are going seamlessly and take corrective action as needed.
Additional Skills:
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Excellent communication and interpersonal skills.
- Positive attitude, disciplined, and punctual.
- Ability to work independently and collaboratively in a fast-paced environment.
- Strong organizational and time management skills.
- Proficient in basic computer operations and a fast learner.
Educational Qualifications: Bachelor's or Master's in Life Sciences: BAMS, BHMS, BDS, BPT/MPT, B Pharm/M Pharm, B.Sc./M.Sc. (Nursing, Nutrition, Zoology, Biology, Biochemistry, Microbiology, Biotechnology, Genetics, Physician Assistant, etc.)
Certification is mandatory: CPC/CRC/CCS, etc
