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Risk Adjustment Coding and Documentation Specialist

Kootenai Health

Facilitate improvements in the overall quality, completeness, and accuracy of practice-based clinical diagnosis coding and documentation.

Responsibilities include:

  • Verifying the accuracy, completeness, specificity, and appropriateness of risk-adjusted diagnosis codes and clinical documentation based on services rendered
  • Supporting and educating KCN clinicians and staff on pre-visit planning, including identifying severity of patient illness
  • Improving the provider coding experience by providing regular feedback on coded cases and opportunities for better documentation
  • Analyzing chart documentation related to clinical status, treatment plans, and past medical history to identify documentation gaps
  • Independently educating clinicians and staff on diagnosis coding and documentation issues
  • Developing program improvement plans and training materials
  • Recommending and educating on appropriate solutions in accordance with nationally recognized coding guidelines
  • Collaborating with payer partners on coding recapture and diagnosis resolution
  • Using software and population health applications to collect, track, and communicate diagnosis coding information
  • Working with Contracting, Analytics, and Information System teams to identify interventions and optimize data, reports, and population health applications
  • Performing other related duties as assigned

Regular and predictable attendance is an essential job function.

Requirements & Qualifications

Minimum Qualifications

  • Graduate of a formal coding program or completion of a coding training course required
  • Associate degree preferred
  • Minimum 3 years of coding or medical record chart review experience in a healthcare setting required
  • Previous Risk Adjustment Methodology and diagnosis coding experience required
  • AHIMA or AAPC coding certification required, such as:
    • CCS
    • CPC
    • CCS-P
    • or other related certification
  • Risk Adjustment Coder certification preferred
  • Experience with Hierarchical Coding Category (HCC) Risk Adjustment Model preferred
  • Knowledge of HCC diagnosis coding and clinical record review processes preferred
  • Strong knowledge of CPT, ICD-10 coding, and medical record documentation
  • Proven project management experience or experience coordinating detailed projects or activities
  • Strong written and verbal communication skills with the ability to build strong relationships

Working Conditions

  • Hybrid schedule available for Idaho residents
  • Must be able to lift and move up to 10 lbs
  • Must be able to maintain a sitting position
  • Typical office equipment use
  • Repetitive movements
Benefits & Perks

Benefits and Perks

  • Comprehensive medical coverage, including fully employer-paid options for eligible full-time employees
  • Affordable medical plans for part-time staff
  • Dental, vision, life, and pet insurance
  • Telemedicine and wellbeing resources available to all employees
  • Tuition assistance after 90 days
  • Retirement plans with pretax and Roth options plus employer matching from 3% to 6%
  • Competitive pay with night, weekend, and PRN shift differentials
  • Award-winning wellness program with coaching, financial wellness resources, and access to fitness centers and premium wellbeing apps
  • PerkSpot discounts across thousands of deals in more than 25 categories
  • Employee referral bonus program

Location

Idaho, US

Employment Type

Full-time

Experience Level

Intermediate Level

Remote work allowed

Yes

Posted

4 weeks ago

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