Risk Adjustment Coder

Community Health Center of Snohomish County offers competitive wages and a comprehensive benefits package designed to address health, time off, retirement and career-advancement needs.  Benefits available include health insurance (medical/dental/vision), up to 120 hours of vacation time pro-rated by FTE every 12 months, paid sick leave, 10-paid holidays, 403(b) Safe Harbor retirement plan with employer match, disability and life insurance, and more! We also offer $0.75/hour for those who test proficiently in a second language.

Job Summary

The Risk Adjustment Coder maintains working knowledge of CHC billing policies and Medicaid, Medicare and other third party insurance billing and compliance requirements.  In addition, the Risk Adjustment Coder maintains a thorough knowledge of the automated billing system and provides technical training and support to CHC staff.  This position collaborates with Quality, Operational staff, providers, and outside agencies such as Medicare and Medicaid. This position provides subject matter expertise to others including staff in Patient Accounts department.

Knowledge, Skills & Abilities

• Reads, speaks, understands and writes proficiently in English.
• Effectively communicates orally and in writing.
• Works independently and is self-directed.
• Works effectively in a team environment.
• Problem-solves with creativity and ingenuity.
• Organizes, prioritizes, and coordinates multiple activities and tasks.
• Works with initiative, energy and effectiveness in a fast-paced environment.
• Produces work in high quantity and quality.
• Represents the organization in a professional and effective manner to the community.
• Knowledge of medical and dental terminology.
• Knowledge of HIPAA regulations and compliance.
• Ability to make decisions regarding sensitive information.
• Knowledge of healthcare revenue cycle functions, including documentation, coding, and billing guidelines.
• Proficiency in the use of Microsoft Office applications; Word, Excel and Outlook.

Preferred:

• Bilingual skills.

Education

• High School diploma or equivalent
• Medical Coding Education
• Bachelor’s or Associate degree in allied health or any related field

Experience

• Five years coding experience in multiple specialties.
• Progressive coding experience including hierarchical condition category coding (HCC)

Credentials

• Certified Professional Coder (CPC) and Certified Risk Adjustment Coder (CRC) must be obtained within nine months of hire.

Other

• Driver's license with the State of Washington.
• Motor vehicle insurance liability policy, a certificate of deposit, or a liability bond to the required limits.

Job Specific Functions/Performance:

1. Review and accurately code medical records and encounters for diagnoses and procedures related to Risk Adjustment and HCC coding guidelines.
2. Validate and ensure the completeness, accuracy, and integrity of coded data.
3. Actively participate in and maintain coding quality and productivity processes.
4. Collaborates with quality team or coding staff on retrospective medical record review for severity, accuracy, and quality issues.
5. Ensure documentation in the medical record follows the official coding guidelines, internal guidelines and the AMA, HCA, and CMS.
6. Assist in internal and external coding audits to ensure the quality and compliance of coding practices.
7. Provide ongoing feedback to physicians and other providers regarding coding guidelines and requirements.
8. Assist with educational in-services for physicians, other providers, and clinic staff relating to coding and documentation compliance as well as new policies and procedures related to billing.
9. Train new coding staff, as needed.
10. Assists with the development, implementation and review of policies and procedures and forms related to areas of responsibility.
11. Adheres to attendance standards in order to perform the job functions for daily operations and/or continuity of patient care.
    

CHC is an Equal Employment Opportunity/Affirmative Action Employer (EEO/AA)/At-will employer.