Coding Specialist -Risk Adjustment

Evergreen Healthcare•Kirkland, WA

54d•$32 - $52

About The Position

Responsible for providing expertise in the area of quality and risk adjustment coding for physicians and other qualified health care providers. Coordinates and collaborates with operational and clinic leadership to assist in the identification of clinical best practices to ensure all diagnoses are captured in accordance with CMS Risk Adjustment coding guidelines.

Requirements

CPC Certification
1 year coding experience
Certified Risk Adjustment Coder (CRC) through the AAPC within one year of hire
Experience with electronic medical record (EMR) system
Knowledge of medical terminology
Experience with HEDIS metrics
Exceptional organizational skills and proven ability to effectively and proactively complete multiple projects simultaneously and meet deadlines
Excellent communication, presentation and interpersonal skills. Must be able to communicate with individuals and groups representing all levels of the organization
Strong attention to detail, accuracy and ability to work independently

Nice To Haves

2 years HCC coding experience for professional services for multiple specialties

Responsibilities

Assists providers in understanding the CMS Risk adjustment program as it relates to payment methodology and the importance of proper chart documentation of procedural and diagnosis coding.
Audits provider documentation in the medical record to ensure adherence with CPT, HCPCS, ICD-10-CM coding and CMS Risk Adjustment guideline; provides thorough, timely, and accurate feedback to providers regarding documentation best practices.
Evaluates HCC (Hierarchical Condition Category) auditing processes and provides analysis and recommendations to improve overall provider documentation and coding.
Supports organizational strategic initiatives by routinely consulting medical providers to clarify missing or inadequate record information and to determine appropriate diagnostic and procedure codes are captured.
Collaborates with clinicians, coders, and other key stakeholders to optimize education and application of HCC coding principles.
Performs other duties as assigned.