ACO Risk Coding Specialist (Hybrid)
About The Position
About Intention Healthcare, An Essen Health Care Company As the largest privately held multispecialty medical group in the Bronx, we provide high-quality, compassionate, and accessible medical care to some of the most vulnerable and underserved residents of New York State. Guided by a Population Health model of care, Essen has five integrated clinical divisions offering urgent care, primary care, and specialty services, as well as nursing home staffing and care management. Founded in 1999, our over 25-year commitment has fueled an unwavering dedication toward innovating a better healthcare delivery system. Intention Healthcare is a division of Essen providing physician house calls, and it is the largest provider of house calls in New York. We provide compassionate medical care and care management services to ensure that our over 22,000 disabled and otherwise homebound seniors can live safely, comfortably, and with dignity in their homes. Job Summary The risk coding specialist will help providers to implement coding guidelines and properly document the disease burden of their patients. They will become experts in HCC-based risk adjustment (prior experience preferred, but not necessary), they will conduct medical chart reviews to identify suspect conditions, and they will design and manage workflows to ensure that providers are made aware of suspect conditions, so that they can evaluate the patient thoroughly and correctly document the patient’s risk factors.
Requirements
- International Medical Degree
- Some amount of experience in health care, preferably in risk coding, or medical scribing
- Ability to function in a fast-paced environment, to be held accountable for high performance standards, and to hold others accountable for high performance
- Strong Familiarity with Electronic Health Records (EHR), able to review a medical chart for evidence of a disease
- Strong understanding of concepts in primary care and geriatric medicine
- Ability to manage and report out KPIs
- Strong data management skills, particularly in Excel
- Strong written communication skills
- Team-based orientation
- Cultural sensitivity and ability to work with diverse team members, both from the US and offshore, and with medical providers
Responsibilities
- Learn the details risk coding and adjustment. What are the categories of diseases that matter, and what are the criteria required for (a) surfacing, (b) proving, and (c) documenting a particular condition.
- Oversee an offshore team in conducting risk coding activities
- Conduct chart reviews to identify suspect conditions and highlight inadequately coded progress notes.
- Design workflows to notify doctors of suspect conditions.
- Ensure incoming labs and diagnostic imaging results relevant to risk adjustment are brought to provider’s attention.
- Education providers on proper documentation and coding guidelines.
- Suggest improvements to team workflows to ensure maximum coding integrity.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed
