Overview of the Role:
We are currently recruiting for two Value-Based Care Documentation and Coding Specialists (one in Virginia and one in Georgia) to join our rapidly growing Revenue Cycle Management team. The successful candidate will have extensive presentation experience in the following areas: ICD-10-CM, CPT and HCPCS.
Primary Job Duties:
Manage Risk Adjustment (RA) provider emails
Conduct risk adjustment audits
Supervise provider Risk Adjustment Boot Camps
Support RA educators with ad hoc provider risk adjustment audits
Use SalesForce issue management to triage and/or answer Risk Adjustment questions
QA records coded by third party vendors monthly
Assist in the implementation and execution of Provider RA Boot Camps
Prepare daily provider risk adjustment stoplight education reports
Disseminate reports to RA educators
Participate in daily provider RA education sprints
Collate coding changes identified in daily RA education calls
Oversee third party vendor claims creation follow up
Identify training priorities and proactively schedule provider training
Perform other related duties, which may be inclusive, but not listed in the job description:
Minimum Qualifications:
Certified Professional Coder (CPC) required; CPC and Certified Risk Adjustment Coder (CRC) preferred
Five years’ experience coding ICD-10-CM
Previous experience with Risk Adjustment training
Possess knowledge of federal laws and regulations, including NCDs and LCDs affecting risk adjustment documentation and coding compliance
Possess knowledge of documentation and coding guidelines established by the Center for Medicare and Medicaid Services (CMS) and the American Medical Association (AMA) for assignment of diagnostic and procedural codes
Experience working with MS Office Suite, Electronic Medical Records, Encoder, Coding Clinic, or other software programs and internet based applications as needed to fulfill position duties
Experience using a Customer Relationship Management (CRM) such as Salesforce preferred
Maintain patient, team member and employer confidentiality; comply with all HIPAA regulations.
Interpersonal Skills & Attributes:
Able to have honest, difficult conversations with providers about diagnosis documentation and code assignment
Establish and maintain effective working relationships with providers, management, clients and staff
Clear and concise oral and written communication
Excellent time management skills
Excellent presentation skills
Express ideas clearly and effectively
Respond calmly and maturely in high pressure situations
Keep a positive attitude toward company, work, clients, management, and team members
Use a customer focused approach in dealing with conflict and resolution of problems
Physical Demands:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; talk or hear; and taste or smell. The employee must occasionally lift or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus.
Privia Health is committed to providing equal employment opportunity to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. In addition, Privia will provide reasonable accommodations for qualified individuals with disabilities. Privia's goal is for our people to reflect the communities that we serve and to increase representation of women, people of color, veterans and individuals with disabilities in our organization.