PACE Medical Coder Professional

4 days ago


Escondido, California, United States Neighborhood Healthcare Full time

Job Title: PACE Medical Coder Professional

Company Overview:

At Neighborhood Healthcare, we are dedicated to providing exceptional care to our seniors. Our PACE program is designed to keep our participants happy and healthy at home, surrounded by their family and community.

About Us:

We are a private, non-profit 501(C)(3) community health organization that serves over 500k medical, dental, and behavioral health visits from more than 90k people annually. With two PACE centers located in Riverside County, our PACE program is positioned to serve over 650 senior participants.

Salary:$30.09 - $38.84 hourly rate, depending on experience, education, and additional qualifications.

Job Description:

The PACE Medical Coder plays a crucial role in the all-inclusive care model of Neighborhood Healthcare PACE. This individual will collaborate with the interdisciplinary care team to ensure accurate abstracting and coding of Hierarchical Condition Categories (HCC) to the highest level of specificity.

Responsibilities:

  • Audits medical record data for adherence to compliance and identifies training opportunities for providers.
  • Abstracts diagnoses from clinical documentation to assign codes to presenting chronic conditions.
  • Analyzes participant clinical charts, diagnosis data, CPT Codes, and any other diagnostic data for PACE organization to assess chart coding accuracy for RAPS submissions.
  • Works collaboratively with PACE providers to develop positive rapport while maintaining the ability to effectively communicate and resolve coding and documentation discrepancies.
  • Identifies educational needs and disseminates clinical coding and documentation references to providers and trainings when needed to provide solutions for improvement of quality and accuracy.
  • Organizes and prioritizes all work to ensure that records are coded in time frames that will be in line with department policies.
  • Utilizes critical thinking to analyze and evaluate documentation issues with consultation from the medical and clinical staff.
  • Develops, implements, and consistently seeks improvement in policies and procedures for all billing and reimbursement functions to ensure department activities are carried out in accordance with industry standards and optimizes revenue.
  • Researches and maintains knowledge and understanding of HCC/risk adjustment, CPT, and ICD-10 coding and documentation requirements per Medicare guidelines.
  • Stays current on Continued Education Units to maintain coding certification.

Required Skills and Qualifications:

  • High School Diploma/GED required, Bachelor's Degree preferred.
  • Current Certification(s) from AAPC or AHIMA (CPC, CRC, CCS, or CCS-P) required.
  • Three years of CPT, ICD-10 coding systems, and chart review experience required.
  • Experience educating healthcare providers regarding coding and documentation preferred.

Benefits:

We offer a competitive salary range of $30.09 - $38.84 hourly rate, depending on experience, education, and additional qualifications. Additionally, we provide a comprehensive benefits package, including partially company-paid Medical, Dental, and Vision Plans, Two plus weeks of vacation, Nine Holidays including two Floating Holidays of your choosing, Sick/Personal time, Volunteer Time Off (VTO), 403b Retirement plan (similar to a 401k), optional Health and Wellness events, and much more.



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