THIS POSITION WILL NOT BE REMOTE!
WellBe Senior Medical is not able to accept Apprentice at this time.
The WellBe care model is a Physician Led Advanced Practice clinician driven geriatric care (care of older adults) team focused on the care of the frail, poly-chronic, elderly Medicare Advantage patients. This population is typically underserved and very challenged with access to care. To address these problems, we have elected to bring the care to the patient, instead of trying to bring the patient to the care. Care is provided throughout the entire continuum of care – from chronic care and urgent care in the home, to hospital, to skilled nursing facility, to assisted living, to palliative care, to end of life care. WellBe's physician/advanced practicing clinician led geriatric care teams’ partner with the patient’s primary care physician to provide concierge level geriatric medical care and social support in the home as well as delivering and coordinating across the entire care continuum.
The Coding Specialist is responsible for performing medical chart audits for ICD-10-CM coding and documentation. Interfaces with clinicians and management on chart audit findings and delivers education to clinicians as needed
SKILLS & COMPETENCIES
- Fosters a culture of best demonstrated practices, customer and peer service-orientation, measurement, performance, accountability and continuous improvement
- Performs medical chart audits on both retroactive and prospective basis to identify, monitor and document claims and encounter coding information as it relates to Hierarchical Condition Categories (HCC)
- Performs coding abstraction and medical chart quality audits to ensure clinicians have accurate clinical documentation to support ICD-10 codes, and are adhering to CMS Risk Adjustment guidelines
- Educates clinicians on specific coding issues found in their charts, and regarding billing and documentation policies and procedures
- Review billing submissions
- Ensures reimbursement is maximized through appropriate coding via implementation of best practices and processes
- Manages annual recoding efforts
- Produces reports showing coding trends, clinician, community, PCP, etc.
- Performs mock RADV audits
- Engages health plans/government agencies
- Reviews and owns all training
- Complies with all aspects of Coding and adheres to official coding guidelines
- Performs auditing analysis and provides feedback on noncompliance issues detected through auditing process
- Stays up-to-date on industry coding and compliance issues
- Other tasks needed to accomplish team’s objectives/goals
Educational/ Experience Requirements:
- 2 years’ post-high school education or a degree from a two-year college
Licensure, Certification, or Regulatory Requirements:
- Coding certification through AAPC or AHIMA required- Certified Risk Adjustment Coder (CRC) & Certified Coding Specialist (CCS-P), CCS, CPC
Required Skills and Abilities:
- Minimum of two (2) years’ experience of ICD-9/10, CPT, HCPCS coding experience
- Experience in healthcare reimbursement or revenue cycle or several years of overall health care experience
- Knowledge of Risk Adjustment and Hierarchical Condition Categories (HCC) and Medicare Advantage reimbursement a plus
- Knowledge of CMS coding guidelines
- Knowledge of Medical Terminology, disease process and anatomy and physiology
- Computer literate with medical billing software
- Proficient in Word, Excel, Microsoft Access
- Innovates new programs
- Execution and result oriented
- Ethics and integrity
- Attention to detail
- Professional demeanor
Supervisory Responsibility: This position will have supervisory responsibility.
Travel requirements:This position will not have 0% travel required.
Work Conditions:Ability to lift up to 20lbs. Moving lifting or transferring of patients may involve lifting of up to 50lbs as well as assist with weights of more than 100lbs. Ability to stand for extended periods. Fine motor skills/Visual acuity .
The preceding functions may not be comprehensive in scope regarding work performed by an employee assigned to this position classification. Management reserves the right to add, modify, change or rescind the work assignments of this position. Management also reserves the right to make reasonable accommodations so that a qualified employee(s) can perform the essential functions of this role
Please No Agency Submission or Inquiries.