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Risk Adjustment Coding and Documentation Specialist

Kootenai Health -
Coeur d'Alene, ID

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Job Details

Full-time

Benefits

Wellness program
Health insurance
Dental insurance
Tuition reimbursement
Vision insurance
Referral program
Retirement plan
Pet insurance

Qualifications

Medical coding experience in physician offices
Medical record abstraction
Stakeholder relationship building
Medical record review for billing accuracy

Full Job Description

Risk Adjustment Coding and Documentation Specialist

Position Summary

This position is responsible for facilitating the improvement in the overall quality, completeness, and accuracy of practice-based clinical diagnosis coding and documentation.

Responsibilities

Verifies and ensures the accuracy, completeness, specificity, and appropriateness of risk adjustable diagnosis codes and clinical documentation based on services rendered

Engages KCN clinicians and their staff by supporting and educating on pre-visit planning to include identifying severity of patient illness

Improves the provider coding experience by ensuring KCN clinicians and their staff receive regular feedback regarding coded cases and opportunities for improved documentation

Supports KCN practices by analyzing chart documentation related to clinical status of patient, current treatment plan, past medical history and identifies potential gaps in provider documentation

Serves as a resource by independently educating KCN clinicians and their staff by identifying errors and issues related to diagnosis coding and documentation to bring about a positive network value program outcome

Develops program improvement plans and training materials

Suggests and educates appropriate solutions in accordance with nationally recognized coding guidelines

Actively engages and collaborates with payer partners on coding recapture and resolution of diagnosis

Utilizes software and population health application to collect, track, and communicate information related to diagnosis coding

Collaborates with KCN Contracting, Analytics and Information System teams to discern appropriate interventions for identified performance opportunities through enhancements or optimization to data, reports and population health application

Performs other related duties as assigned

Familiar with standard concepts, practices, and procedures within the field

Relies on experience and judgment to plan and accomplish goals

Regular and predictable attendance is an essential job function

Competent to meet age specific needs of the unit assigned

Requirements and Minimum Qualifications

Graduate of a formal coding program or completion of a coding training course required

Associate degree preferred

Minimum 3 years' coding/medical record chart review experience in a healthcare setting required

Previous Risk Adjustment Methodology and diagnosis coding experience required

Coding certifications through AHIMA or AAPC; Outpatient Coding: Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) or Certified Coding Specialist-Physician, (CCS-P), or other related certification required

Certification as Risk Adjustment Coder preferred

Experience with Hierarchical Coding Category (HCC) Risk Adjustment Model preferred

HCC diagnosis coding and clinical record(s) review process preferred

Strong knowledge of CPT and ICD-10 coding and medical record documentation

Proven history of project management and/or coordinating detailed projects or activities

Strong written and verbal communication skills, including ability to establish and build strong relationships

Working Conditions

This position is on-site in Coeur d'Alene Idaho; Hybrid schedule available for Idaho residents

• Must be able to lift and move up to 10lbs

Must be able to maintain a sitting position

Typical equipment used in an office job

Repetitive movements

About Kootenai Health:

Kootenai Health is a highly esteemed healthcare organization serving patients throughout northern Idaho and the Inland Northwest. We have been recognized with many accolades and distinctions, including being a Gallup Great Workplace, No. 1 Best Place to Work in Large Healthcare Organizations, and Magnet™ Status for Nursing Excellence. We pride ourselves on our outstanding reputation as an employer and a healthcare provider.

As your next employer, we are excited to offer you:

Comprehensive medical coverage, including fully employerpaid options for eligible fulltime employees, plus affordable plans for parttime staff. Benefits begin on the 1st of the month following 30 days of employment.

Dental, vision, life, and pet insurance, with telemedicine and wellbeing resources available to all employees

Tuition assistance after 90 days to support your professional growth

Retirement plans with pretax and Roth options and employer matching from 3%–6%

Competitive pay, plus night, weekend, and PRN shift differentials

Awardwinning wellness program with coaching, financial wellness resources, and free or discounted access to fitness centers and premium wellbeing apps

PerkSpot discounts providing access to thousands of exclusive deals in over 25 categories

And an employee referral bonus program

Kootenai Health provides exceptional support for extraordinary careers. If you want to work on a high-quality, person-centered healthcare team, we can't wait to meet you!

Apply today!

Kootenai Health complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, veteran status, or sex. Kootenai Health does not exclude people or treat them differently because of race, color, national origin, age, disability, veteran status, or sex.

#KHHP25

Location: Kootenai Health · Kootenai Care Network
Schedule: Full Time, Days

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