Risk Adjustment Coding Specialist (28517)

at  Family Care Network

Title: Risk Adjustment Coding Specialist
Location: Administrative Office - Patient Accounts Department
City: Bellingham, WA
Position: Full time 40 hours, Monday-Friday 8:00am-5:00pm, non-exempt (hourly)
Compensation: The full wage scale is $24.25 - $33.95 per hour. Placement within the range is determined by an evaluation of the candidate’s background, education, and experience.
Bonus: Employees are eligible annually to participate in discretionary bonus programs, as determined by FCN, which include the Years-of-Service bonus program, the Quality Performance bonus program and Performance Recognition bonus programs.
Job Summary: Primary responsibility is to assess Risk Adjustment / HCC coding practices for Family Care Network Practitioners and billing staff ensuring that regulations are being followed

We are looking for a qualified, motivated individual who can:

• Review medical record information to identify, collect, assess, monitor, and document claims and encounter coding information as it pertains to Hierarchical Condition Categories (HCC).
• Audit provider documentation of CPT and ICD-10 codes to ensure adherence with coding and CMS Risk Adjustment guidelines.
• Evaluate HCC audit processes and provide analysis and recommendations to improve overall provider documentation and coding.
• Responsible for ongoing provider education on HCC.
• Support and participate in process and quality improvement initiatives.
• Meet productivity and quality standards.
• Review Comprehensive Health Assessment forms.
• Performs other duties, as required.

ESSENTIAL KNOWLEDGE, SKILLS AND ABILITIES:

• Extensive experience with healthcare coding and billing processes.
• Knowledge of Medicare managed care.
• Familiarity with EMR software.
• Extensive knowledge of CPT and ICD Codes.
• Demonstrate analytical and problem-solving ability regarding barriers to receiving and validating accurate HCC information.
• Must be able to achieve and maintain an accuracy standard of 95% or better.
• Intermediate computer skills: Word, Excel and Outlook.
• Commitment to discern and maintain confidentiality, in compliance with applicable State & Federal laws (i.e., HIPAA).
• Strong experience solving problems and addressing concerns in a collaborative manner; knowing when to request support from a supervisor.
• Ability to work both independently and as part of a team.
• Actively support and promote a positive work and team ethic.
• Proven internal and external customer service skills.
• Proven ability to prioritize and multi-task detailed projects despite frequent interruptions.
• Proven ability to understand and communicate information accurately and clearly verbally and in writing, in person and over the telephone.
  About FCN: As an independent, locally owned, provider-run network of family medicine providers, we are passionate about our community’s well-being. We take the time to build strong, long-term relationships with our patients and our employees. We have 11 clinics and 3 urgent care centers in Whatcom and Skagit County, in a beautiful corner of northwest Washington where the mountains meet the sea. Family Care Network offers an innovative and rewarding work environment, with a strong patient focus and a fulfilling mission.

REQUIRED EDUCATION & EXPERIENCE:

• High school diploma or equivalent
• Two or more years of medical office experience required
• Five or more years of biller/coder experience required
• Certified Medical Coder with CPC and one or more of the following required:

Please refer the Job description for details