Job Description Summary

The Code Review Supervisor is responsible for oversight of a team of Code Review Processors ensuring all SLAs are consistently met along with additional duties.

Job Duties

Operational

Ensure all client Service level Agreements are consistently met and all penalties are avoided.

Identify the processing, procedural and billing errors and practices that lead to claims inaccuracies and propose ways to systemically address.

Develop, enhance and improve policies, procedures and workflow processes associated with claims review.

Support other departments in problem resolution as necessary.

Complete required reports and ad hoc requests for information.

Develop reporting templates and dashboards to drive efficiency, increase productivity and improve quality through metrics and standards.

Consulted often by others for advice and opinions and recognized as a leadership role model.

Management

Manage team 12 – 18 direct reports.

Evaluate team priorities to ensure they are realistic and relevant.

Establish accountability for performance through the communication of SMART goals and behavioral competency expectations.

Monitor productivity and quality to ensure SLAs and timelines are met.

Provide regular, honest feedback on performance.

Provide guidance and training to drive performance and assist in colleague development.

Qualifications

Certified Professional Code (CPC) strongly preferred

Certified Professional Medical Auditor (CPMA) is preferred but not required

Certified Medical Chart Auditor-E/M (CMCA-E/M) is preferred but not required

7+ years of business experience in healthcare/insurance with increasing responsibility

Strong project management and interpersonal skills, makes sound decisions, exhibits initiative and intuitive thinking.

Problem solving, strong analytical skills, people skills, teamwork, people management, and managing processes.

Strong interpersonal skills for interfacing with all levels of internal and external audit teams and management.

Ability to prioritize and multi task.

Associate Degree required, BA or BS preferred.