Remote QCDI Coding Specialist – HCC & Payer Insights

Dignity Health Medical Group; Rancho Cordova (CA); On-site; USD 90,000 - 130,000; Full time

Benefits offered by this job

Equipment provided for remote work

Job summary

Dignity Health Medical Foundation is seeking a Quality Clinical Documentation Improvement (QCDI) Coding Specialist to ensure comprehensive capture of HCCs and accurate reimbursement. You will review charts, educate providers, and identify opportunities for improved coding and performance metrics.

This remote role is open to residents of California, with equipment provided for home use. A CPC or CCS certification and strong knowledge of payer guidelines are required, along with 5 years of clinic

Qualifications

• 5 years experience as a clinic coder
• Extensive knowledge of payer contract guidelines
• Certified Professional Coder (CPC) or Certified Coding Specialist (CCS)
• Analytical and problem solving skills with the ability to understand clinical compliance guidelines, complex reimbursement structures and to apply contractual and governmental regulations to internal processes. Superior organizational skills. Superior written and verbal communication skills. Able to work with minimum daily supervision.

Responsibilities

• Performs comprehensive chart reviews to ensure documentation required to facilitate the reporting of HCC diagnoses to payer
• Identifies claims correction opportunities and submits to appropriate personnel for processing
• Demonstrates analytical and problem-solving ability regarding review of submitted diagnosis codes versus services reflected in the documentation in the patient's chart note
• Follows department policies and guidelines on appropriate documentation to billing codes, abstracting information from chart notes based on performance program measures
• Partners with QCDI Nurse, as necessary, to identify trends and gaps for creating better process efficiency and provider performance
• Assists in the development and reporting of HCC and Pay for Performance Metrics

Skills

Clinic coding

Payer contract guidelines

Analytical skills

Communication skills

Education

Bachelor's degree or equivalent

CPC or CCS certification

Job description

Dignity Health Medical Foundation is seeking a Quality Clinical Documentation Improvement (QCDI) Coding Specialist to ensure comprehensive capture of HCCs and accurate reimbursement. You will review charts, educate providers, and identify opportunities for improved coding and performance metrics.

This remote role is open to residents of California, with equipment provided for home use. A CPC or CCS certification and strong knowledge of payer guidelines are required, along with 5 years of clinic