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Medical Quality Coder/Auditor Job in Vista, California

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Job Title: Medical Quality Coder/Auditor

Employer:	Vista Community Clinic
Type:	FULL TIME
Location:	1000 Vale Terrace Vista 92084, CA, US
Date Posted:	2/28/2019

Vista Community Clinic is a private, non-profit, multi-specialty outpatient clinic providing care in a comprehensive, high quality setting. Located in San Diego, Orange and Riverside counties, we work to advance community health and hope by providing access to premier health services. We are looking for dedicated, motivated, enthusiastic team players who want to make a difference in the community. Competitive compensation and benefits program includes health, dental, vision, company-paid life, flexible spending accounts and a 403(B) plan, for eligible employees. VCC is an equal opportunity employer.

Overview:

Responsible for system wide requirements for accuracy in documentation to include ICD-10 and CPT codes, ensuring Quality Measures and Preventive services are completed for patients required by Managed Care, CMS, and Medicare Advantage guidelines
Collaborate with IT and other departments as needed to ensure appropriate ICD-10 and CPT codes are updated annually in Electronic Medical Records (EMR) system
Identify opportunities for improvement and apply appropriate process improvement methodologies
Review patient medical records for HEDIS measures determined by the organization
Accurately audit and review diagnoses codes to ensure highest level of specificity
Accurately audit and review CPT procedures for appropriate services
Review and update encounter documents on a continuous basis, ensuring completeness and accuracy with identification of problem trends affecting HCC, communicate correct coding to Clinicians
Assist in the development of training materials with Clinical Quality Manager and staff
Assist Clinical Quality Manager and staff in writing/establishing operating procedures to meet coding regulations/compliance and follow-up enhancement

Minimum

High school graduate or equivalent
Coding certification, preferably HCC Coder (Certification from AHIMA and/or AAPC)
Minimum three years' medical coding experience ; Minimum two years' medical auditing experience
Coding compliance program implementation experience
Knowledge of Quality metrics and HEDIS
Proficient ion Microsoft suite of products: Excel, Outlook, Word, PowerPoint

Preferred

Two years' experience in an FQHC environment
Experience with NextGen
Coding compliance program implementation experience

Required Skills/Knowledge/Abilities

Knowledge of Medicare, Medi-Cal/Presumptive Eligibility, FPACT, Every Woman Counts, Tricare and Managed Care Payors
Knowledge of payor coding policies and guidelines for FQHC’s
Familiar with medical terminology and strong data entry skills