Introduction Do you have the career opportunities as a Risk Adjustment Coder you want with your current employer? We have an exciting opportunity for you to join HCA Healthcare which is part of the nation's leading provider of healthcare services, HCA Healthcare.
Benefits HCA Healthcare, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:
- Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
- Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
- Free counseling services and resources for emotional, physical and financial wellbeing
- 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
- Employee Stock Purchase Plan with 10% off HCA Healthcare stock
- Family support through fertility and family building benefits with Progyny and adoption assistance.
- Referral services for child, elder and pet care, home and auto repair, event planning and more
- Consumer discounts through Abenity and Consumer Discounts
- Retirement readiness, rollover assistance services and preferred banking partnerships
- Education assistance (tuition, student loan, certification support, dependent scholarships)
- Colleague recognition program
- Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
- Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.
Learn more about Employee Benefits
Note: Eligibility for benefits may vary by location. Our teams are a committed, caring group of colleagues. Do you want to work as a(an) Risk Adjustment Coder where your passion for creating positive patient interactions are valued? If you are dedicated to caring for the well-being of others, this could be your next opportunity. We want your knowledge and expertise!
Job Summary and Qualifications The Risk Adjustment Coder works in a collaborative effort directly with physicians and their office staff and other support departments to review medical records and other clinical documentation to identify appropriate risk adjustment codes and quality gap closure opportunities.
A major focus of the position is to collect and review documents to support the organization's quality and risk adjustment initiatives, which results in improving quality of care.
What qualifications you will need: ESSENTIAL JOB DUTIES/RESPONSIBILITIES: - Ensures compliance with all applicable Federal, State and/or County laws and regulations related to coding and documentation guidelines for Risk Adjustment Reviews of medical records, patient medical history and physical exams, physician orders, progress notes, consultation reports, diagnostic reports, operative and pathology reports, and discharge summaries to verify whether:
- The diagnosis codes are supported by the documentation and ensure with ICD-10-CM Guidelines for Coding and Reporting.
- The diagnosis codes for each chronic or major medical condition have been captured correctly.
- Any diagnosis code that is unsubstantiated by the record should be queried to provider and assess to accuracy.
- Reviews for clinical indicators and query providers to capture the severity of illness of the patient.
- Conducts medical charts to identifying opportunities for improving individual member risk adjustment score accuracy.
- Provides feedback to internal clients on:
- Examples of documentation and physician self-coding that do not meet quality standards.
- Examples of missed operations missed opportunities.
- Examples of clinical that ensure quality and timely care of our members as well as correct reimbursement.
- Identifies clinical coding and documentation trends and training needs to improve the quality of documentation to reflect our patients' health data.
- Attends all meetings as required.
- Other duties as assigned and modified at manager's discretion.
KNOWLEDGE, SKILLS & ABILITIES: - Advanced understanding of medical terminology, body systems/anatomy, physiology and concepts of disease processes.
- Demonstrated ability to utilize a variety of electronic medical records systems.
- Ability to manage significant work load, and to work efficiently under pressure meeting established deadlines with minimal supervision.
- Strong time management skills.
- Excellent written and oral communication for representation of clear and concise results.
- Strong follow-up skills & organizational skills required.
- Must possess high degree of accuracy, efficiency and dependability.
- Candidate will work from home.
Travel required 0-10%
EDUCATION AND EXPERIENCE CRITERIA: - High School Diploma or GED required.
- Coding Certificate required. AAPC or AHIMA coding certified preferred.
- CRC (certified risk coder) is required, or minimum of 3-5 years' experience in risk adjusting coding in lieu of certificate.
- Two (2) + years' experience in a primary care environment is required.
- Strong knowledge of Microsoft Office Suite (Excel-basic mathematical formulas, charts, tables).
- Strong medical coding and third party operating procedures and practices.
- Knowledge of CPT/ICD-9 & 10 & Medical Terminology.
- 2 years experience Required Years of Experience
Nashville-based HCA Healthcare is one of the nation's leading providers of healthcare services. Founded in 1968, HCA Healthcare created a new model for hospital care in the United States. In this model, we use combined resources to improve hospitals, deliver patient-focused care, and improve the practice of medicine. We have conducted several clinical studies. One of those studies includes a demonstration that full-term delivery is healthier than early elective delivery of babies. Another study identified a clinical protocol that can reduce bloodstream infections in ICU patients by 44 percent. We are a learning health system that uses its more than 31 million annual patient encounters to advance science, improve patient care and save lives. HCA affiliated facilities in the North Florida Division are a part of a quality healthcare network in North Florida. This network includes 15 affiliated hospitals, 5 surgery centers, and two consolidated service centers. Together, our network has over 3,100 beds, employs more than 14,000 team members, and has over 4,200 physicians on staff.
HCA Healthcare has been recognized as one of the World's Most Ethical Companies® by the Ethisphere Institute more than ten times. ?In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.
"Bricks and mortar do not make a hospital. People do."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder
If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our Risk Adjustment Coder opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews.
Unlock the possibilities and apply today! We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.