Coding Specialist -Risk Adjustment

Evergreen Health; Kirkland (WA); On-site; USD 80,000 - 100,000; Full time

Job summary

A healthcare provider in Kirkland is seeking a qualified individual for a role focused on quality and risk adjustment coding. Responsibilities include auditing provider documentation, offering guidance on best practices, and collaborating with various healthcare professionals. The ideal candidate should have CPC Certification and at least one year of coding experience, with additional experience in HCC coding desired.

Benefits

Medical, vision and dental insurance

Tuition assistance for undergraduate and graduate degrees

Paid Time Off/Vacation

Retirement plans with employer contribution

Commuter benefits

Qualifications

• CPC Certification is mandatory.
• 1-year coding experience is required.
• Knowledge of HEDIS metrics is a plus.

Responsibilities

• Provide expertise in quality and risk adjustment coding.
• Audit provider documentation for coding adherence.
• Consult with medical providers on coding practices.

Skills

CPC Certification

1 year coding experience

Excellent communication skills

Knowledge of medical terminology

Education

Certified Risk Adjustment Coder (CRC)

Tools

Electronic medical record (EMR) system

Job description

Wage Range: $32.27 - $51.64 per hour

Posted wage ranges represent the entire range from minimum to maximum. For jobs with more than one level, the posted range reflects the minimum of the lowest level and the maximum of the highest level. Some positions also offer additional premiums based on shift, certifications or degrees. Job offers are determined based on a candidate's years of relevant experience, level of education and internal equity.

Job Summary

Responsible for providing expertise in the area of quality and risk adjustment coding for physicians and other qualified health care providers. Coordinates and collaborates with operational and clinic leadership to assist in the identification of clinical best practices to ensure all diagnoses are captured in accordance with CMS Risk Adjustment coding guidelines.

Primary Duties

• Assists providers in understanding the CMS Risk adjustment program as it relates to payment methodology and the importance of proper chart documentation of procedural and diagnosis coding.
• Audits provider documentation in the medical record to ensure adherence with CPT, HCPCS, ICD-10-CM coding and CMS Risk Adjustment guideline; provides thorough, timely, and accurate feedback to providers regarding documentation best practices.
• Evaluates HCC (Hierarchical Condition Category) auditing processes and provides analysis and recommendations to improve overall provider documentation and coding.
• Supports organizational strategic initiatives by routinely consulting medical providers to clarify missing or inadequate record information and to determine appropriate diagnostic and procedure codes are captured.
• Collaborates with clinicians, coders, and other key stakeholders to optimize education and application of HCC coding principles.
• Performs other duties as assigned.

License, Certification, Education or Experience

REQUIRED for the position:

• CPC Certification
• 1 year coding experience
• Certified Risk Adjustment Coder (CRC) through the AAPC within one year of hire
• Experience with electronic medical record (EMR) system
• Knowledge of medical terminology
• Experience with HEDIS metrics
• Exceptional organizational skills and proven ability to effectively and proactively complete multiple projects simultaneously and meet deadlines
• Excellent communication, presentation and interpersonal skills. Must be able to communicate with individuals and groups representing all levels of the organization
• Strong attention to detail, accuracy and ability to work independently

DESIRED for the position:

• 2 years HCC coding experience for professional services for multiple specialties

Benefit Information

Choices that care for you and your family. At EvergreenHealth, we appreciate our employees’ commitment and contribution to our success. We are proud to offer a suite of quality benefits and resources that are comprehensive, flexible, and competitive to help our staff and their loved ones maintain and improve health and financial well-being.

• Medical, vision and dental insurance
• On-demand virtual health care
• Health Savings Account
• Flexible Spending Account
• Life and disability insurance
• Retirement plans 457(b) and 401(a) with employer contribution
• Tuition assistance for undergraduate and graduate degrees
• Federal Public Service Loan Forgiveness program
• Paid Time Off/Vacation
• Extended Illness Bank/Sick Leave
• Paid holidays
• Voluntary hospital indemnity insurance
• Voluntary identity theft protection
• Voluntary legal insurance
• Pay in lieu of benefits premium program
• Free parking
• Commuter benefits
• Cafeteria & Gift Shop Discount