Senior Coder, Risk Adjustment

UHS•Reno, NV

1d•Hybrid

About The Position

Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience. Job Summary: The Senior Coder is responsible for documentation and coding review of medical records where services are rendered at various partnered medical practices. Will work with assigned provider offices to ensure accurate reporting of diagnoses and service codes to support optimal performance in risk adjustment and quality measurement. The scope of work will include pre, post and wraparound visit input. The Senior Coder will be required to work occasionally onsite at the provider office and may require travel to out of state for in person provider education and training. The Senior Coder will be required to maintain consistent and reliable methods of communication to accommodate the hours and demands of providers’ schedules.

Requirements

University/college degree, or equivalent medical records, claims or billing experience
3+ years in CMS coding and documentation guidelines as well as HCC risk adjustment coding practices
CRC Required.
2+ years in Risk Adjustment Coding
Experience working in a variety of EMRs and the ability to navigate and pick up EMR applications
Strong understanding and knowledge of CMS Coding and Documentation Guidelines
Demonstrated competency in HCC coding practices.
Proficient with MS Office Suite (Word, Excel, Outlook), Internet and databases
Knowledge of age-specific needs and elements of disease processes and related procedures required.
Strong broad-based clinical knowledge and understanding of pathology/physiology of disease processes.
Ability to read and write effectively in English
Highly organized, proficient critical-thinking and analytical problem-solving skills
Ability to work independently in a time oriented environment is essential.

Nice To Haves

Additional Coding certification preferred (CCS, CPC, or RHIT)
Must be credentialed through AAPC or AHIMA.
Working knowledge of inpatient admission criteria, Medicare reimbursement system and coding systems preferred, but not required.
Previous medical office experience preferred.
bi-lingual Spanish preferred

Responsibilities

Documentation and coding review of medical records where services are rendered at various partnered medical practices.
Work with assigned provider offices to ensure accurate reporting of diagnoses and service codes to support optimal performance in risk adjustment and quality measurement.
Perform pre, post and wraparound visit input.
Occasionally work onsite at the provider office.
May require travel to out of state for in person provider education and training.
Maintain consistent and reliable methods of communication to accommodate the hours and demands of providers’ schedules.