Healthcare Coding Specialist
2 weeks ago
Career Opportunities:
Healthcare Coding Specialist - Payment Integrity
Job Summary
The Healthcare Coding Specialist is tasked with conducting thorough code evaluations and overseeing chart auditing processes. This role is essential in educating healthcare providers and internal teams on coding standards and practices.
Key Responsibilities:
- Conduct and support various coding-related audits for healthcare providers and associated entities.
- Assist with audits related to Risk Adjustment Data Validation (RADV) and other diagnosis coding.
- Review medical documentation to ensure accurate diagnosis codes are reflected in claims and retrospective reviews.
- Communicate findings and recommendations for enhancement to providers as necessary.
- Establish and maintain systems for tracking audit outcomes and results.
- Identify, monitor, analyze, and report trends discovered during audits.
- Create and maintain centralized documentation and training resources to aid in the education of providers and internal stakeholders.
- Develop educational materials in various formats, including recorded training sessions and reference documents.
- Stay informed on the latest coding guidelines and regulations by regularly consulting current manuals and attending relevant workshops.
- Maintain active coding certification and seek out emerging best practices through networking and professional associations.
- Serve as a subject matter expert on correct coding practices.
Organizational Responsibilities:
- Align work with the organization's mission, vision, and values.
- Support the commitment to equity, diversity, and inclusion by fostering a culture of respect and awareness.
- Strive to achieve annual business objectives in line with the organization's strategic goals.
- Adhere to organizational policies and compliance requirements.
- Perform additional duties as required.
Qualifications:
Required:
- Minimum of 2 years of experience as a certified coder.
- Active coding certification from AHIMA or AAPC.
Preferred:
- Certified Risk Adjustment Coder (CRC) or similar certifications.
- Experience in leading educational presentations for medical professionals.
- Knowledge of risk adjustment principles.
Knowledge, Skills, and Abilities:
- In-depth understanding of diagnosis coding conventions set by CMS and AMA.
- Proficient in reading and interpreting medical terminology and documentation.
- Ability to work effectively with electronic health record (EHR) systems.
- Strong computer skills, including proficiency in Microsoft Office Suite.
- Analytical and problem-solving skills.
- Excellent written and verbal communication skills.
- Ability to teach and coach adult learners effectively.
- Strong attention to detail and ability to work independently.
Working Conditions:
- Indoor office environment with potential for community facility exposure.
- May require occasional travel for professional development.
Commitment to Diversity:
CareOregon encourages candidates from diverse backgrounds to apply, fostering a linguistically and culturally inclusive work environment. We are an equal opportunity employer, considering all candidates regardless of their background.
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