Clinical Coding Supervisor

Regular
Exempt

GENERAL DESCRIPTION:
Responsible for the operation of the units that manage the Comprehensive Health Risk Assessment (CHRA), retrospective projects, and clinical coding processes. Guarantees compliance with established procedures following operational guidelines and rules established by the different accrediting agencies, such as Medicare.
ESSENTIAL FUNCTIONS:
•Oversees CHRA’s post-payment audit process, monitoring that the execution of the processes is carried out within the established time.
•Guarantees that the second-level coding audit of medical records is carried out in the established time, coordinating and monitoring the execution of the project.
•Oversees compliance with the referral process of operational processes, guarantees that they are distributed to the appropriate units, monitors their status, and ensures that the processes are completed to complete the referrals.
•Reviews the results of the coding audits performed by the Pre-Audits area in Premium Handling.



Ensure that the findings are discussed with the employee and that the corrective action plan is completed where applicable. Submit the results to the Pre-Audits area.
•Identifies situations that may represent a risk in the fulfillment of the unit’s objectives, goals, and operational procedures, such as data entry errors, coding errors, production problems, and corrective action plans that Information Technology (IT) may need to implement as a result of the findings, to establish alternatives, and refer them to the management for evaluation and approval.
•Prepares and delivers statistical reports related to the Scorecard within the established time.
•Supervises the operational process for the generation of the deleted indicators referred to the Premium Management Pre-Audits unit.
•Reviews operational guidelines to make modifications and/or add new tasks, as applicable, and reports their recommendations to the management.
•Requests the IT Department repo

📌 Clinical Coding Supervisor (San Juan)
🏢 MCS Healthcare Holdings, LLC (MCS)
📍 San Juan