Risk Adjustment Coder-2

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team.

Job Summary

Responsible for providing accurate, reliable and effective education to physicians and extenders regarding outpatient procedural and diagnosis coding. This position performs individual and group documentation reviews, identifies opportunities for improvement, assists with implementation of physician lead CME documentation and coding courses and coordinates with physician leadership and other resources to develop and deliver educational programming. The incumbent will provide their coding expertise to help better educate physicians and support staff in coding procedures that more accurately meet billing compliance requirements.

Job Description

Minimum Qualifications

Education: Associates degree required; in lieu of degree, minimum of two (2) years of progressive experience in outpatient physician documentation and Risk Adjustment; Bachelor’s degree preferred

Licenses/Certifications: One of the following licenses is required:

• Certified Coding Specialist (CCS), or

• Certified Professional Coder (CPC), or

• Certified Coding Specialist-Physician Based (CCS-P), or

• Clinical Documentation Expert (CDEO), or

• Certified Risk Adjustment Coder (CRAC), or

• Certified Professional Medical Auditor (CPMA), or

• Certified Coding Associate (CCA)

Experience / Knowledge / Skills:

• Five (5) years of progressive experience in outpatient physician documentation and Risk Adjustment and a minimum of two (2) years specifically in a multi-specialty practice environment.

• Advanced working knowledge of ICD-10, CPT, HCPCs, compliance and coding requirement. HCC Risk Adjustment experience required

• Expertise in risk factor calculations

• Possess computer skills, operating systems and EMRs

• Demonstrate a high level of organizational and planning skills with the ability to work independently

• Requires excellent observation skills, analytical thinking, problem solving and possess superior verbal and written communication skills with the ability to adapt style and tone according to situation and audience

• Experience in adult learning principles to be able to provide adult education and training

Principal Accountabilities

• Provides documentation and coding education to physician and their support staffing virtually or in their designated clinics.

• Conducts research to update education materials for providers.

• Interprets changes in external regulatory environment and coding updates.

• Plans and conducts on-going training with providers and support staff.

• Provides coding expertise and serves as subject matter expert to respond questions from providers, office staff and others relating to procedural coding and ICD-10 coding, regulations and documentation requirements.

• Maintains project work list and meets deadlines.

• Seeks appropriate physician input if required information is missing or unclear.

• Maintains current knowledge of outpatient coding. Follows coding compliance guidelines, official coding guidelines, regulatory requirement and internal policies and procedures affecting the coding process.

• Ensures safe care to patients, staff and visitors; adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service.

• Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency; supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor and resource to less experienced staff.

• Demonstrates commitment to caring for every member of our community by creating compassionate and personalized experiences. Models Memorial Hermann’s service standards by providing safe, caring, personalized and efficient experiences to patients and colleagues.

• Other duties as assigned.

Originally posted on Himalayas