Risk Adjustment Coding Specialist

Family Care Network•Bellingham, WA

5d•$26 - $35

About The Position

Primary responsibility is to assess Risk Adjustment / HCC coding practices for Family Care Network Practitioners and billing staff ensuring that regulations are being followed We are looking for a qualified, motivated individual who can: Review medical record information to identify, collect, assess, monitor, and document claims and encounter coding information as it pertains to Hierarchical Condition Categories (HCC). Audit provider documentation of CPT and ICD-10 codes to ensure adherence with coding and CMS Risk Adjustment guidelines. Evaluate HCC audit processes and provide analysis and recommendations to improve overall provider documentation and coding. Responsible for ongoing provider education on HCC. Support and participate in process and quality improvement initiatives. Meet productivity and quality standards. Review Comprehensive Health Assessment forms. Performs other duties, as required.

Requirements

Extensive experience with healthcare coding and billing processes.
Knowledge of Medicare managed care.
Familiarity with EMR software.
Extensive knowledge of CPT and ICD Codes.
Demonstrate analytical and problem-solving ability regarding barriers to receiving and validating accurate HCC information.
Must be able to achieve and maintain an accuracy standard of 95% or better.
Intermediate computer skills: Word, Excel and Outlook.
Commitment to discern and maintain confidentiality, in compliance with applicable State & Federal laws (i.e., HIPAA).
Strong experience solving problems and addressing concerns in a collaborative manner; knowing when to request support from a supervisor.
Ability to work both independently and as part of a team.
Actively support and promote positive work and team ethic.
Proven internal and external customer service skills.
Proven ability to prioritize and multi-task detailed projects despite frequent interruptions.
Proven ability to understand and communicate information accurately and clearly verbally and in writing, in person and over the telephone.
High School Diploma, GED or equivalent knowledge and skills obtained through a combination of education, training, and experience.
Two or more years of medical office experience required
Five or more years of biller/coder experience required
Certified Medical Coder with CPC and one or more of the following required:
Minimum of two years HCC coding experience required
Ability to obtain CRC within 1 year

Nice To Haves

Responsibilities

Assess Risk Adjustment / HCC coding practices
Review medical record information to identify, collect, assess, monitor, and document claims and encounter coding information as it pertains to Hierarchical Condition Categories (HCC).
Audit provider documentation of CPT and ICD-10 codes to ensure adherence with coding and CMS Risk Adjustment guidelines.
Evaluate HCC audit processes and provide analysis and recommendations to improve overall provider documentation and coding.
Responsible for ongoing provider education on HCC.
Support and participate in process and quality improvement initiatives.
Meet productivity and quality standards.
Review Comprehensive Health Assessment forms.
Performs other duties, as required.

Benefits

Three Medical plan options
Two Dental plans, including orthodontia for children and adults
Employer-paid Vision coverage for employee and family
Expanded Employee Assistance Program (EAP) and mental health programs, including wellness and discounted gym memberships
Flexible Spending Account (FSA), Healthcare and Dependent Care
Health Savings Account (HSA) with an employer contribution of $1,500 (pro-rated based on enrollment eligibility)
Health Reimbursement Account (HRA), up to $1,500 ($3,000 for family coverage)
Employer-paid Life/AD&D insurance with optional supplemental additional coverage including a guaranteed issue amount with no health questionnaire
Voluntary Accident and Hospital insurance plans with annual wellness benefits
Paid Time Off (PTO), Paid Sick Leave (PSL), and Extended Illness Bank (EIB) to support your vacation, health, and personal needs
Full-time employees generally begin earning 18 days of PTO, increasing 33 days over time per our PTO policy. You can rollover unlimited PTO hours into the next year.
PSL accrues at 1 hour per 40 hours worked
EIB accrues up to 32 hours per year (pro-rated based on hours worked) for both part-time and full-time employees, with a maximum of 480 hours
401(k) plan with employer match, both Traditional and Roth options available
401(k) Profit Sharing Plan
Free financial planning guidance to support your retirement goals
Eligibility for FCN applicable bonuses