Certified Risk Adjustment Coder

Mount Sinai Medical Center•Hialeah, FL

3d•Onsite

About The Position

As Mount Sinai grows, so does our legacy in high-quality health care. Since 1949, Mount Sinai Medical Center has remained committed to providing access to its diverse community. In delivering an unmatched level of clinical expertise, our medical center is committed to recruiting and training top healthcare workers from across the country. We offer the latest in advanced medicine, technology, and comfort in 12 facilities across Miami-Dade (including our 674-bed main campus facility) and Monroe Counties, with 38 medical services, including cancer care, 24/7 emergency care, orthopedics, cardiovascular care, and more. Mount Sinai takes pride in being South Florida's largest private independent not-for-profit hospital, dedicated to continuing the training of the next generation of medical pioneers. Culture of Caring: The Sinai Way Our hardworking, tight-knit community of more than 4,000 dedicated employees fosters an environment of care and compassion. Each member plays a vital role in our collective mission to deliver excellent healthcare through innovation, education, and research. At Mount Sinai, we take pride in our achievements, aiming to be a beacon of quality healthcare in South Florida. We welcome all healthcare professionals to join our thriving community and contribute to our pursuit for clinical excellence.

Requirements

CPC, CCS-P or CRC Certification Required
High School graduate
Five plus years experience in Coding and Billing
Knowledge of ICD-10-CM and CPT

Responsibilities

Demonstrates knowledge of coding and documentation standards as well as CMS risk adjustment guidelines and HCCs (hierarchical condition categories)
Reviews medical record to ensure all diagnosis codes are documented for the assignment of a valid and accurate HCC for each episode of care
Regularly reviews Epic HCC and payor CSI (Clinically Suspect Conditions) reports
Queries and provides feedback and education to physicians when identifying documentation deficiencies to improve accuracy of risk adjustment coding
Demonstrates understanding of risk adjustment payment models
Uses clinical reasoning and critical thinking skills to discern the financial impact of a query in order to prioritize efforts most efficiently
Completes patient medical chart review within 24-48 hours of visit completion
Responsible for maintaining active status of coding credentials and completes annual continued education hours.
Observes work hours and provides proper notice regarding absences and tardiness
Maintains positive working relationship with Physician Practices, Managed Care and all other departments and communicates with office staff as needed.
Performs other related duties.