资深风险调整医学编码员 - CRC 远程

HealthPartners is hiring a Risk Adjustment Coding Analyst Senior.
This position is responsible for diagnosis coding review and vendor coding quality assurance; working to ensure that plan performance and plan revenue is based on an accurate representation of our population’s care needs and risks.
ACCOUNTABILITIES:

• Performs retrospective chart review for diagnosis coding accuracy.

• Identifies, analyzes, and reports coding error trends to inform risk adjustment analytics and deliver provider education.

• Reviews vendor coding and provide recurring feedback and education to vendor team.

• Participates in internal and CMS-mandated risk adjustment data validation review.

• Identifies, documents, and messages process improvements, clinical documentation improvements and/or other educational opportunities.

• Develops and performs training and educational seminars to physicians and advanced practice providers on risk adjustment topics.

• Increases collaborative efforts between HealthPartners Health Plan and HealthPartners Medical Group as it relates to optimization of diagnosis coding.

• Analyzes and organizes complex information for effective reporting to leadership.

• Conducts daily work consistent with HealthPartners core values and comply with all federal and state regulations.

• Maintains confidentiality of protected health information.

• Increases organizational efficiency in daily operations.

• Responsible for other duties as assigned.

REQUIRED QUALIFICATIONS:

• High School Diploma or GED or Associate’s degree in a related field

• One of the following credentials required: RHIA, RHIT, CPC, CCS, CCS-P

• Certified Risk Adjustment Coder (CRC) credential

• Minimum of five years experience with diagnosis coding review as a certified coder

• Demonstrated working knowledge of the revenue cycle process, claims processing, retrospective chart review process, compliance and federal/state regulations, CPT, ICD-9, and ICD-10 coding

• Identify issues and formulate solutions relating to retrospective chart review process improvement initiatives

• Understand and communicate clinical documentation requirements for correct coding and to ensure integrity of the medical record

• Skill and experience in effectively collaborating with team members & others using oral, written and interpersonal communications

• PC skills in Microsoft Word and Excel

• Organize and prioritize multiple assignments

• Ability to deal with change and ambiguity

• Able to work, both, as a team member or independently

PREFERRED QUALIFICATIONS:

• Four year college degree

• Experience working with Epic

Originally posted on Himalayas