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Healthcare Coding Adjustment Expert
2 months ago
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 function as a resource to existing staff for projects and daily work.
- 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.
- Perform other related duties as assigned.
- 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.
- 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.
