Risk Adjustment HCC Coder- CDS

Overview

Are you a certified primary care medical coder who’s passionate about improving the accuracy and integrity of patient records? Valley wise Health wants you to join our mission-driven team focused on providing exceptional patient care through precise and compliant documentation. In this critical role, you will collaborate with providers, coders, and clinical teams to ensure the outpatient medical record tells the full story of the patient’s encounter.

Your work will directly impact quality reporting, revenue cycle performance, and patient outcomes.

Under the direction of the Clinical Documentation Improvement (CDI) Supervisor, this Outpatient Clinical Documentation Specialist (CDS)-I position uses your coding knowledge and understanding of ICD-10 coding guidelines and standards of compliance to improve the overall quality and completeness of clinical documentation within the patient electronic medical record using a concurrent and/or retrospective review process. You will work with CDI nurses to ensure that the clinical information within the medical record is accurately coded and supported by the provider’s documentation during the time of the visit.

This includes accurate documentation to support the capture of Hierarchical Condition Categories (HCC), Risk Adjustment Factors (RAF), and ICD-10-CM specificity. You will also perform retrospective reviews and apply ICD-10-CM and CPT codes to ensure services are captured on the claim form and compliant with all applicable federal laws and regulations related to coding and documentation guidelines for HCC capture. You may participate in ongoing documentation improvement initiatives, including formal and informal education provided to outpatient providers by the CDI team.

Valley wise Health is committed to providing high-quality, comprehensive benefits designed to help our employees and their families stay physically and financially fit. Benefits include:

• Medical, Dental, and Vision Plans
• Flexible Spending Accounts
• 100% Retirement Match in the Arizona State Retirement System (ASRS)
• Paid Time Off and Paid Holidays
• Sick and Extended Illness Bank
• Tuition Reimbursement Programs
• And much more!

Hourly Rate: $34.15 - $50.37

• Requires an associate degree in Health Information Technology (HIT) or an equivalent combination of training and experience in place of HIT degree.

• Requires three (3) years of experience coding in a primary care provider’s office or facility-based provider clinic for internal medicine/family practice.
• Must know coding Medicare Annual Wellness Visits and HCC reporting guidelines.
• Prefers to have experience with HCC Coding.
• Prefers to have value-based reporting experience.

• Requires the ability to pass a coding exam before hire.
• Requires experience with Electronic Health Record systems, Encoder, and Microsoft Office software.
• Prefers experience with EPIC and 3M Encoder Software Systems.

• Must possess a CCS, CCS-P, COC, or CPC certification.
• Must possess a valid driver’s license.
• Prefer Certified Risk Adjustment Coder (CRC) and Certified Clinical Documentation Specialist-Outpatient (CCDS-O).

• Must have in-depth knowledge and a clear understanding of coding principles to validate and apply missing, incomplete, or incorrect diagnosis ICD-10-CM & CPT codes.
• Must be able to demonstrate the difference between a problem-oriented visit, a preventative visit, and the Annual Wellness Visit criteria.
• Must clearly understand Hierarchical Condition Categories (HCC) and Risk Adjustment Factors (RAF).
• Must be able to demonstrate advanced knowledge of medical terminology, anatomy, and physiology.
• Must be able to communicate and have excellent customer service skills with physicians and ambulatory clinic staff about documentation and coding.
• Must be able to achieve and maintain appropriate CDS productivity standards established in the CDI Department Policy and Procedure.
• Must abide by the Standards of Ethical Coding set forth by the American Health Information Management Association (AHIMA) and AAPC.
• Must have a high level of understanding of computer applications,…