RISK ADJUSTMENT CODING ASSOCIATE II

GALEN MEDICAL GROUP PC•Hixon, TN

5d•Onsite

About The Position

The EMR Coding Auditor II (ECA II) facilitates improvement in the overall quality, completeness, and accuracy of medical record documentation. The individual will perform medical record reviews based on CMS Quality Standards and validating active chronic problems for each patient and communicating with the physician to ensure Hierarchical Condition Coding is met, as well as accurate and up-to-date patient problem lists are documented in the EMR. This position will interact with physicians, coding staff and other members of the health care team to ensure the accuracy and completeness of clinical documentation to support resource utilization and patient outcomes. The ECA II will be the designated trainer for new team members and provide training and support to others in the team as needed and under the direction of the Population Health Manager.

Requirements

Must be certified as procedural coder and maintain certification throughout employment.
Must have strong analytical, oral and written communication skills.
Minimum of two years of healthcare experience required with one-year clinical experience preferred.
Minimum of two years of customer service experience required.
Must be PC literate with strong computer navigational skills, as well as extensive knowledge of Windows and Microsoft Office.
Knowledge of basic medical terminology.
Proficient with processes to build teams and participate in cross-functional teams.
Ability to work within specified timeframe requirements, including timeframes for goal achievement.
Must be a team player and provide excellent customer service while assessing our patients needs efficiently.
Perform all duties in compliance with Galen Medical policies, HIPAA, and OSHA standards.

Nice To Haves

HCC/risk adjustment coding experience
Associates Degree in related field preferred.

Responsibilities

Coordinate Patient Services
Train new EMR Coding Auditors on processes and procedures of the role.
Provide support for the EMR Coding Auditor team.
Attend Payer based coding training available and share resources to the EMR Coding Auditor team.
Perform medical chart reviews to confirm adherence to AAPC clinical coding guidelines.
Complete audits daily to validate compliance with quality standards and HCC documentation.
Queries the provider to educate and improve individual patient documentation in the EMR.
Protect self and other team members by following all compliance, HIPAA and infection prevention guidelines and regulations.
Respect patients by recognizing their rights; maintaining confidentiality.
Assist patient’s primary care provider with coordination of care/services to ensure the smooth transfer of member information across the continuum of care.
Maximize the use of resources to improve quality outcomes with reduction of unnecessary tests/procedures maintaining accurate and complete documentation in the medical record.
Proactively engage with patients, family and/or caregivers to educate and coordinate completion of necessary procedures or tests.
Establish and Maintain Quality Care Population Health Coordination
Independently monitors and reviews an assigned patient population.
May provide telephonic outreach to patients identified as high risk, with chronic condition(s) to assist with medical record requests, as needed.
Thorough understanding of ICD-10, CPT and complex co-morbidity coding.
Maintains professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal networks, benchmarking state-of-the-art practices and participating in professional organizations regarding clinical quality measures and governmental regulations.
Promote the mission, vision, and values of Galen Medical Group.
Report to work on time and as scheduled.
Represent the organization in a positive & professional manner.
Must adhere to HIPAA guidelines at all times in order to maintain the highest level of patient confidentiality.
Comply with all organization policies and procedures.
Participate in performance improvement and continuous quality improvement activities.
Attend regular staff meetings and in-services as directed.
Consistently demonstrate the value of the team concept.
Other duties as assigned.