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Clinical Documentation Specialist III

2 months ago

Port Charlotte, Florida, United States Millennium Physician Group Full time
Job Summary

We are seeking a highly skilled Medical Coding Specialist III to join our team at Millennium Physician Group. As a key member of our healthcare team, you will be responsible for reviewing provider responses to suspected conditions and validating these responses against the entire patient medical record.

Key Responsibilities
  • Act as a preceptor to new employees during the orientation process and facilitate ongoing training for optimal staff functioning.
  • Optimize our billing processes, maintain compliance, and educate providers in a visually engaging way.
  • Analyze and audit findings to identify areas for improvement in provider documentation practices.
  • Maintain active professional certification and comply with all educational, professional, and ethical requirements of said certification.
  • Demonstrate knowledge of health systems operations, including an understanding of reimbursement methodologies and coding conventions.
  • Demonstrate ability to perform accurate and complete chart reviews for Hierarchical Condition Categories (HCC)/Risk Adjustment.
  • Conduct medical record reviews to evaluate documentation to ensure that diagnosis coding meets specificity requirements to support clinical indicators.
  • Monitor reviews for potential risks to the organization and escalate as needed to the leadership team.
  • May occasionally lead workgroups and manage project deliverables for department initiatives, audits, and provider communications.
  • Provide written or oral recommendations to department leadership related to process improvements, root-cause analysis, and/or barrier resolution applicable to Risk Adjustment initiatives.
  • Demonstrate ability to identify and communicate trends in provider coding and documentation.
  • Provide feedback to the direct supervisor of concerns and underperforming providers.
  • Coordinate with provider education team to assist educational efforts.
  • Possess excellent written, verbal, communication, and attention to detail skills.
  • Collaborate and work in tandem with other members of the MRA Department.
  • Demonstrate excellent guest service to internal team members and patients.
Requirements
  • High school Diploma or GED equivalent
  • 2+ years of experience, in a payer or healthcare-related field
  • 3+ years of HCC Coding experience, preferred
  • Certified Procedural Coder (CPC), CRC designation preferred
  • Certified Documentation Expert Outpatient (CDEO), OR AAPC or AHIMA Approved coding credential, or equivalent
  • Must be proficient in 10-key, Word, and Excel
  • Maintains active professional certification and adheres to all industry educational, professional, regulations, and ethical requirements
  • Perform Internal Coding Audits on Prospective and Concurrent coders/auditors and provide feedback and support
  • Organizational skills with a focus on tracking patient care and improving patient flow
  • Proven knowledge of compliance and up-to-date guidelines regarding applicable coding and documentation
  • Understands and complies with policies and procedures for confidentiality of all patient records, HIPAA, and security of systems
  • Possesses excellent attention to detail
  • Ability to maintain a consistent accuracy rate of 95% or above
  • Must be able to meet productivity standards established by Leadership
  • Ability to work independently in a fast-paced, cross-functional environment
Benefits
  • 3 weeks PTO & 7 paid holidays
  • Medical, Dental, Vision
  • Employer Paid Basic Life & Short Term Disability coverage (goes into effect after 1 year of full-time employment)
  • 401(k) with match
  • Employee Wellness
  • Other Employee Discount programs like Tickets at Work and cell phone discounts
  • Other benefits: Dependent Care FSA, Voluntary Life, Long Term Disability, Critical Illness, Pet Insurance, and more