HCC Coding Quality Educator at St. Tammany Parish Hospital

Kennesaw, Georgia, United States -

Full Time

Start Date

Immediate

Expiry Date

19 Jun, 26

Salary

0.0

Posted On

21 Mar, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

HCC Coding, Medical Record Documentation, Risk Adjustment, ICD-10-CM, CPT/HCPCS, E/M Standards, Auditing, Documentation Guidelines, HIM Projects, Tableau, Excel, Word, PowerPoint

Industry

Hospitals and Health Care

Description

At St. Tammany Health System, delivering world-class healthcare close to home is our goal. That means we are committed to attracting and retaining the very best professionals for every position in our health system. We believe the pristine beauty of St. Tammany Parish adds to our attractive compensation package. The health system is nestled in the heart of Covington on the north shore of Lake Pontchartrain. It is a peaceful, scenic, community-oriented area with an abundance of amenities to suit every taste. JOB DESCRIPTION AND POSITION REQUIREMENTS Scheduled Weekly Hours: 40 JOB SUMMARY: The HCC Coding Quality Educator (HCQE) facilitates the improved integrity of medical record documentation through interaction with healthcare providers to support the appropriate representation of severity of illness, risk of mortality, acuity, and complexity of care. In addition, this position, through a multidisciplinary team approach, performs pre-visit and retrospective reviews of ambulatory clinical documentation to ensure an accurate depiction of the true complexity of the patient to support the facilities Risk Adjustment strategy. The HCQE utilizes their coding knowledge, and demonstrates an understanding of current CMS coding guidelines, the impact of procedures and compliant documentation to support the capture of Hierarchical Condition Categories (HCC), ICD-10-CM accuracy and specificity, and medical necessity. They work collaboratively with ambulatory physicians and advanced practice providers to communicate opportunities and educate members of the patient care team regarding documentation guidelines, coding requirements and service-line specific requirements. Auditing professional records to provide education to the physicians and clinical colleagues as required. The HCQE will also ensure that all diagnoses, therapeutic interventions, and procedures codes are assigned in accordance with current ICD-10, CPT/HCPCS and E/M standards. Codes are assigned in compliance with AMA, CMS, NCQA, official coding guidelines, and other regulatory agency standards. Other duties assigned will be responsible for managing the entire life cycle of assigned Health Information Management projects by directing and coordinating the activities, evaluating workflows to ensure efficient processes and problem-solving services. MINIMUM QUALIFICATIONS: Bachelor of Science degree in Nursing OR Health Information Management obtained from an accredited school of Nursing or Health Information Management; OR 3-5 years of clinical/coding experience with Risk Adjustment AND professional coding experience. CPC, CCS, or other related coding certifications. Knowledge of ICD-10, CPT, HCPCS Level II and III, APC, APG, professional modifiers, revenue codes, CCI edits. Proficiency in Microsoft Office Application (PowerPoint, Excel, Word, and Tableau). Preferred Qualifications: Experience with Medicare Risk Adjustment, Hierarchical Condition Categories, coding, billing, and auditing; extensive Outpatient CDI and Risk Adjustment Coding knowledge. RN/HIM professional with current ACDIS Certified Clinical Documentation Specialist (CCDS), AHIMA Certified Documentation Practitioner (CDIP), or CCS/CPC. PHYSICAL DEMANDS: Must possess good physical health. Some requirements include but are not limited to standing, sitting or walking for long periods of time. Lifting at least 10 pounds is required. Must be able to work with a moderate level of noise. Physical Effort required: Constant (67%-100%) - handling/feeling, talking, hearing, seeing Frequently (34%-66%) - NONE Occasionally (1%-33%) - lifting, carrying, pushing/pulling, balancing, stooping, crouching, reaching EMPLOYMENT Each St. Tammany Health System staff member is expected to conduct himself or herself according to our mission, vision and values. Please take time to review those expectations, which can be found by clicking here, before applying for employment. If you feel you are unable to demonstrate those characteristics, we respectfully request that you do not proceed with the application process. EQUAL OPPORTUNITY EMPLOYER St. Tammany Health System is an Equal Opportunity Employer. St. Tammany Health System is committed to equal employment opportunity for all employees and applicants without regard to race, color, religion, sex, age, national origin or ancestry, citizenship, sexual orientation, gender identity, veteran status, disability status, genetic information or any other protected characteristic under applicable law. St. Tammany Health System is a full-service acute care facility that delivers today’s life-improving procedures with the latest technology, highest quality and the utmost care to area residents. From wellness and prevention to diagnosis, treatment, rehabilitation and recovery, the St. Tammany Health System delivers the very latest technology, the most accomplished specialists and highly personalized, caring staff to ensure patients and their families receive world-class healthcare close to home. St. Tammany Health System is an independent service district in a clinically integrated partnership with Ochsner Health System. Together, the two organizations focus on aligning their healthcare offerings to best serve patients and families in west St. Tammany Parish and surrounding areas.

Responsibilities

The HCC Coding Quality Educator facilitates improved medical record documentation integrity by interacting with healthcare providers to accurately represent patient severity and complexity to support the facility's Risk Adjustment strategy. This role involves performing pre-visit and retrospective reviews, utilizing coding knowledge to ensure accurate capture of Hierarchical Condition Categories (HCC) and ICD-10-CM specificity, and educating the patient care team on documentation requirements.