Clinical Operations Risk Adjustment Coder

Description:
? Review of medical records as needed (MRR, OR1, any backlog) and assist platform clients as needed with backlog, larger chart page counts
? Work population of clinical pends, with goal to clear within 72 hours
? Updating and maintaining training course material for medical record abstraction and data entry (HEDIS, RISK, IVA)
? Reviewing training test scores and sending feedback if necessary
? Assigning and overreading disciplinary charts- (this is a chart move back) all projects
? Reviewing reports daily for QA scores during the season(s) (abstractors, coders, HPs)
? Maintaining an accuracy score of 95% on all work submitted (all projects)
? Ability to adapt to changing priorities in managing a wide range of projects.
? Must be able to work independently and in a team environment
? Remote mentoring/ coaching (for all projects) in a group or 1:1 session with staff and leadership
? Client trainings (Reveleer technology, if needed)
? Over read challenges for all projects (reviewing abstractor/coder OR1 feedback challenges)
? Oversite and coordination of IVA documentation audits: ENR/RXC/ATT/DOB/GEN- Assist in training and successful adoption of Natural Language Processing/? Bot? -assisted coding reviews and relating tools/reporting
? Reviewing reports for workload assignments, looking at inventory by project to make sure sufficient headcount are assigned per workload (all projects)
? Multi time zone coverage/ shift coverage- evening/ weekends/holidays
? Managing and addressing questions and clarifications that coders submit to a designated online communication forum and ?Q&A? email mailbox while reviewing charts
? Works actively to monitor and maintain minimum 95% accuracy in all coding projects by providing coaching/feedback to coders, as well as researching literature and attending professional seminars, workshops and conference as required by AAPC and/or AHIMA to maintain professional certification(s).
? Stay up to date with Risk/IVA protocols (coding clinics, coding guidelines)
? Maintain ongoing communication with Clinical Management team regarding coding workload, turnaround time expectations and deliverables
? Additional duties as necessary to meet the obligations to our clients

Requirements: ? Current Coding Certification (CPC, CPC-P, CPC-H, CPC-I, CRC, CCS) through AAPC and/or AHIMA. ? Minimum of 5 years coding experience with specific knowledge of Medicare and Commercial Risk Adjustment such as Hierarchical Condition category (HCC) ? Additional experience in facility (OPPS/IPPS) coding experience is preferred ? Additional experience in Health Plan Risk Adjustment Data Validation Audit (RADV) experience is preferred ? Ability to work independently in a fast-paced remote environment with minimal supervision and guidance ? Ability to interact with management and remote coding personnel ? Possess strong organizational skills and attention to detail ? Ability to adapt to changing priorities while managing a wide range of projects ? Adaptive and flexible to new ideas and change ? Advanced knowledge of medical terminology, anatomy and pharmacology ? Advanced skills utilizing official coding resources for research and problem solving ? Advanced skills and knowledge of computers, use of required software to perform job functions ? Excellent written and communication skills and the ability to explain complex information

Benefits:

Apply Job!

For more such jobs please click here!