Quality Coding and Documentation Educator, Geisinger Health Plan (Pennsylvania resident)

Geisinger

8d • Remote

About The Position

Provides training and process improvement efforts across the clinical practices for the development of consistent and comprehensive clinical practices supported by the the Health Plan. Identifies process improvement opportunities associated with the management of risk adjustment initiatives. Investigates current processes, assessing efficiency and accuracy and provides solutions for problems, process improvement, development of training programs, and documentation strategies that support ICD-10 complex terminology for clinical practice operations and management.

Requirements

• High School Diploma or Equivalent (GED)
• Minimum of 1 year-Related work experience
• Certified Coding Specialist - American Health Information Management Association (AHIMA)
• Certified Professional Coder - American Academy of Professional Coders (AAPC)
• Certified Risk Adjustment Coder - American Academy of Professional Coders (AAPC)
• Registered Health Information Technician (RHIT) - American Health Information Management Association
• Computer Literacy
• Critical Thinking
• Interpersonal Communication
• Organizing

Responsibilities

• Reviews the content of the medical record professional outpatient records to identify all diagnosis codes applicable to the documentation.
• Carefully reviews details of documents such as laboratory findings, radiology reports, various scanned reports, discharge summaries, history and physical, consultations, orders, progress notes and other ancillary services treatment records needed to ensure all pertinent diagnoses are recorded.
• Translates all diagnostic and procedural phrases utilized by healthcare providers into coded form correct procedure codes as required.
• Using the Encoder software program, determines the codes for all diagnoses
• Reviews and understands annual mapping of ICD-9 and ICD-10 crosswalk.
• Provides education material to the team to educate physicians as needed to clarify documentation within the patient’s record to facilitate complete and accurate coding.
• Assists in decision making relevant to physician coding education and HCC targeting purposes.
• Works one-on-one with physicians as needed to clarify documentation within the patient’s record as appropriate accurate and complete coding.
• Assumes a supporting co-educating role with regard to Risk Adjustment Education and other opportunities for internal education team and external identified opportunities.
• Presents with full understanding of reports, presentations, maps and graphs, reflecting the collaboration of external and internal parties, summary and translation of data into actionable information.
• Delivers presentations to clinicians and administrators.
• Shares condition-specific training modules as requested.
• Works with provider sites to define solutions to needs or problem areas, and determines scope of investigation required to obtain solution.
• Solutions may include installation of alternate methods and procedures, changes in methods and practices, or redesign of products or services.
• Interprets and recommends actionable plans using financial and analytical data prepared by risk adjustment analysts.
• Provides consultative support to clinical areas on a daily basis and recommends operational strategies to achieve optimal documentation and coding processes.
• Assists in proactive risk adjustment communication, support and education at all levels within the organization.
• Accountable for satisfying all job specific obligations and complying with all organization policies and procedures.

Benefits

• We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners.
• Perhaps just as important, we encourage an atmosphere of collaboration, cooperation and collegiality.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees