HCC Coder

MyMichigan Health • Midland, MI

1d • Onsite

About The Position

The HCC Coder, working under the direction of the Clinical Documentation Integrity Manager, utilizes coding expertise to identify areas of opportunity that impacts the quality and the completeness of the medical record documentation. Through prospective, concurrent, and retrospective evaluation of the medical record documentation, the HCC Coder will be responsible for working collaboratively with the clinical team members to support the capture of Hierarchical Condition Categories (HCCs) and ICD-10-CM specificity of ambulatory visits. The HCC Coder utilizes knowledge of coding guidelines, coding/billing compliant practices, HCCs, and clinical knowledge to identify opportunities to capture chronic conditions that affect the patient’s health status and predict future health care costs. MyMichigan Health is a technology driven organization and employees need to demonstrate competency in Microsoft Windows. An employee may be required to participate in further learning opportunities offered by MyMichigan Health.

Requirements

• One of the following certifications are required: Certified Professional Coding (CPC) certificate or Certified Coding Specialist Physician Office (CCS-P) certificate required.
• Strong interpersonal, written, and communication skills required.
• Being an effective educator, self-starter, and highly organized is required.
• Ability to exercise initiative and judgment is required.
• Knowledge of terminology and anatomy.
• Must be able to occasionally (0-33% of the workday) lift or carry 0-10 lbs.

Nice To Haves

• Registered Health Information Technician (RHIT) or Registered Health Information Technician preferred.
• Four (4) years’ experience in the medical field preferred.
• Two (2) years physician coding and billing experience preferred.
• One (1) year with direct physician contact preferred.
• Knowledge of Word, Excel, and PowerPoint is preferred.

Responsibilities

• Uses established technology to accurately process HCC opportunities utilizing claims and clinical data to facilitate Provider HCC capture during the patient encounter.
• Consistently maintains quality and productivity standards to include daily opportunity review targets.
• Participates in orientation and training of new and established providers in the documentation HCC capture utilizing established technology. Educates medical staff on compliant HCC captures and RAF score optimization. Participates, as needed, in providing 1:1 and/or group education to clinical team members and/or colleagues in the utilization of software to facilitate HCC capture to positively impact Risk Adjustment Factor (RAF) scores
• Understands risk adjusted payment methodologies, HCC assignment and payment methodology, professional coding and billing, outpatient facility coding and billing, APC assignment, and OPPS reimbursement methodology and shares this knowledge with colleagues and clinical team members.
• Leads efforts to evaluate HCC documentation and provides recommendations to improve documentation and coding.
• Leads and/or actively participates in meetings. Actively participates in department performance improvement and employee engagement activities.
• Performs all other duties or special projects requested by coding leadership and proactively communicates any problems that arise to maintain a smooth operation of the department.
• Exhibits enthusiasm for the profession, embraces educational opportunities and department support offered and remains engaged in the goals and the vision of the department. Role models the professional standards of behavior and encourages all staff to do the same.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED