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Risk Adjustment Coding Coordinator Job in Plano, Texas

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Job Title: Risk Adjustment Coding Coordinator

Employer:Catalyst Health Network
Type:FULL TIME
Skills:HCC coding for various Managed Medicare products
Specialties:Clinically Integrated Network
Preferred Certifications:CPC or CRC
Required Experience:1 to 2 years
Preferred Experience:3 to 4 years
Location:8277 Belleview Drive,Plano 75024, TX, US
Date Posted:12/4/2020

Role and Responsibilities

The Coding Coordinator, under the direction of the Program Manager, is responsible for performing comprehensive medical chart reviews for the diagnosis code assignment and accuracy of HCC codes in various Managed Medicare products (e.g. Medicare Shared Savings Plan, Medicare Advantage) for an assigned Provider Network partnering with the Accountable Care Organization (ACO). This position is also responsible for identifying documentation deficiencies to be communicated back to the provider for improved accuracy in risk adjustment coding.

 

Core Functions

 

  • Medical chart review to identify new risk adjustment codes using CMS-HCC methodology and ICD-10 CM coding guidelines
  • Review potential risk adjustment codes for accuracy and provide evidence, recommendations, and documentation needed for codes
  • Prep provider charts with code recommendations and quality gaps in care.
  • Complete all provider chart reviews within designated timeframes
  • Assist in the arrangement of Provider follow-up appointments and delivery of care
  • Assist with data entry, faxing, filing and other clerical tasks

·       Support and participate in process and quality improvement initiatives

  • Advanced understanding of Managed Medicare Clinical Quality measures, Risk Adjustment and overall framework of the Managed Medicare products
  • Identify opportunities for improved processes and Provider Group participation in established ACO Managed Care programs.
  • Continuous mindset toward efficiency and process improvement – how to apply technology and processes to improve delivery and efficiency from both the Provider Group and internal perspective
  • Professionally represent the organization at all times; support the mission, goals and objectives; participate as a “team player”, constantly supporting other managers; set an example of high personal and professional conduct for employees and others
  • Comply with all departmental policies and procedures
  • Participate in departmental and company in-services as appropriate
  • Perform other related duties as assigned

 

Qualifications and Education Requirements

  • Medical Assistant, Licensed Vocational Nurse, or equivalent clinical work experience. High school graduate. Some college education preferred in the allied health professional field of study.
  • Medical/clinical background highly desirable
  • 1+ years of ICD10 coding experience
  • Knowledge of CMS HCC Model and Guidelines along with ICD 10 Guidelines
  • Preferred CRC or CPC certification
  • Preferred 1-2 years’ experience in a physician’s office.
  • Reliable transportation and the ability to travel between ACO member offices
  • Excellent written/verbal communication skills, especially the ability to communicate telephonically in a professional and effective manner
  • Confident working with heath care professionals
  • Passionate about your work and move forward with purpose; demonstrate clear value and support of your Provider Groups and internal teams
  • Approach problem solving that involves systems thinking – understanding how the process works and how people are impacted by your decisions
  • Strong communication skills – understanding the need for being inclusive for effective results; communicate effectively with both day to day operational resources and executive management.
  • Understand sense of urgency and fast-paced; strong organizational skills
  • Solutions oriented, willing to bring Provider Groups results regardless of roles or titles
  • Experience with basic Microsoft Office Applications
  • Experience in EHR preferred

 

Applying

Job Invitation – Coding Coordinator

 

Any career with Catalyst Health begins with a passion for #HelpingCommunitiesThrive.  This is not just our mission but allows each and every unique team member to contribute directly to our success by improving the health care of our communities through exceptional and rewarding work.  Our population health team serves physicians, insurance carriers and employers, touching the lives of millions of patients by improving their health while also decreasing overall health care costs – not only for you, the individual, but for our entire health care system by keeping you and your family out of the hospital.

Some of the things you’ll get to do to contribute to our mission and impact our communities as a Coding Coordinator:

·       Have the mind for logistics and the heart for teaching when working with our highly engaged physician offices.  You’ll have a positive and direct impact on the success of our network.

·       Educate our physicians on Standards of Ethical Coding regarding HCC/Risk Adjustment.

·       Work closely with physicians and payers to ensure all suspect conditions are addressed with adequate and clear medical coding requirements.

·       Participate in regular team meetings and educational sessions.

 

 

Look at what we’ve done so far:

·       Voted one of the Top 100 Places to Work in 2020 in the Dallas Morning News

·       Increased our network to nearly 1,000 primary care providers

·       $55+ million saved for our community in the past 3 years

·       Improved clinical outcomes

·       8% improvement in preventative cancer screenings

·       A1c reduction from 9.99 to 7.55 in uncontrolled diabetic cohort

·       Thousands of personal relationships built

·       Increased our product base and workforce

·       Strengthened our corporate culture

·       URAC Accreditation

·       Nearly 67,000 patients touched

·       The Risk Adjustment Coding Team has doubled in the last year, with 100% team year over year retention

 

 

This is what our Team Members say about us:

·       "I feel that my ideas and contributions are valued and legitimately taken into consideration here."

·       "A peaceful work environment that also allows for career growth within the company."

·       "The volunteering opportunities serve as an extension of the company’s core values. It’s encouraged by leadership and there is something for everyone."

·       "Truthfully, the company’s core values of serving the community are exemplified every single day by everyone that works here."

 

Our Core Values, Culture and Mission tie us together as One Team with One Dream.

Sound exciting?  Want to join our mission?  Are you ready to be part of the solution and join a company with a culture that cares?  Good news – we’re always looking for exceptional talent.

Click this link to apply:  https://stratifihealth.apscareerportal.com/j/0nrld2

When applying please enter AAPC in the referral field of the application.


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