Job Description
HealthCare Partners, IPA and HealthCare Partners, MSO together comprise our health care delivery system providing enhanced quality care to our members, providers and health plan partners. Active since 1996, HealthCare Partners (HCP) is the largest physician-owned and led IPA in the Northeast, serving the five boroughs and Long Island. Our network includes over 6,000 primary care physicians and specialists delivering services to our 125,000 members enrolled in Commercial, Medicare and Medicaid products. Our MSO employs 200+ skilled professionals dedicated to ensuring members have access to the highest quality of care while efficiently utilizing healthcare resources.
HCP’s vision is to be recognized by members, providers and payers as the organization that delivers unsurpassed excellence in healthcare to the people of New York and their communities. We pride ourselves on selecting the most qualified candidates who reflect HCP’s mission of serving our members by facilitating the delivery of quality care. Interested in joining our successful Garden City Team? We are currently seeking a
Supervisor of Medical Coding. Position Summary: The Coding Supervisor is responsible for overseeing and managing the day-to-day operations related to Affordable Care Act, Medicaid and Medicare coding, project creation/assignment, and compliance. This role ensures accurate and compliant diagnostic capture and validation, adherence to CMS/NYSDOH regulations, staying current with all industry regulations, and acting as the subject matter expert within this area. The supervisor will lead a team of coding specialists, providing training, quality oversight, and performance management. The position also involves collaborating with internal departments, such as Risk Adjustment, Provider Relations, Compliance, and Quality, to ensure streamlined processes and continuous improvement.
Essential Position Functions/Responsibilities: - Lead, mentor, and develop a team of coding specialists.
- Assign and monitor work tasks, ensuring productivity and accuracy standards are met.
- Conduct regular team meetings to address issues, share updates, and provide ongoing education.
- Oversee Affordable Care Act, Medicaid and Medicare diagnosis capture, ensuring accuracy and compliance with CMS/NYSDOH guidelines.
- Ensure all coding and auditing practices align with federal, state, and organizational regulations.
- Perform regular audits to identify and correct coding errors.
- Collaborate with compliance teams to implement corrective action plans as needed.
- Provide regular training and updates to staff on Affordable Care Act, Medicaid and Medicare regulatory changes.
- Ensure team members maintain current certifications and stay informed on industry trends.
- Develop and distribute reference materials or job aids to support accurate coding and billing.
- Generate provider coding and documentation training materials.
- Generate and analyze reports on coding accuracy and audit result trends to determine course of action.
- Support external audits and coordinate with auditors as needed.
- Communicate effectively with providers to resolve coding and documentation issues.
- Collaborate with Risk Adjustment Integrity Director on programs/projects to enhance the accuracy and compliance of all coding activities.
- Work cross-functionally with internal and external stakeholders to drive continuous improvement.
- Perform other duties as assigned.
Qualification Requirements:
Skills, Knowledge, Abilities - Current Certified Professional Coder (CPC) credential through AAPC or equivalent.
- Strong knowledge of CMS/NYSDOH guidelines, coding policies, and payer-specific requirements.
- Ability to analyze claims data, identify trends, and implement process improvements.
- Strong supervisory skills with the ability to lead and develop a team. Excellent written and verbal communication skills.
- Understanding of Affordable Care Act, Medicare & Medicaid payment methodology
- Highly proficient with computer skills including working knowledge of Microsoft Office products
- Detail-oriented, with a commitment to accuracy and integrity
- Ability to effectively manage multiple projects and deadlines.
- Ability to work with internal and external resources to drive results.
- Ability to handle tight timeframes and meet multiple deadlines.
Training/Education: - Bachelor’s degree in healthcare administration, business, or a related field preferred.
- Equivalent experience with a relevant certification may be considered in lieu of a degree.
Experience: - Minimum of 5 years of experience in Affordable Care Act, Medicaid and Medicare coding and auditing.
- At least 2 years of supervisory or team leadership experience in a healthcare setting.
- Experience with CMS/NYSDOH audits, corrective action plans, and staff training.
Base Compensation: $85,000 - $95,000 annual
Bonus Incentive: Up to 10% of base salary
HealthCare Partners, MSO provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, or genetics. In addition to federal law requirements, HealthCare Partners, MSO complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training. The above position information is intended to describe the general nature and level of work being performed by the job incumbent(s) and is not to be considered an all-encompassing description of all responsibilities, duties, and skills required.
Job Tags
Full time, Local area,