Coding Educator 2 - WAH Arizona Colorado New Mexico - Travel required

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Job Information

Humana

Coding Educator 2 - WAH Arizona, Colorado, New Mexico - Travel required

in

Phoenix

Arizona

Description

Our search is focused on identifying a certified coder who will primarily be responsible for conducting prospective and concurrent reviews to identify documentation improvement opportunities according to CMS and ICD-10 risk adjustment coding guidelines. In this role you will be working collaboratively with providers, coder, and/or office staff performing coding and review onsite. Part of the job will be also taking ownership of Medicare risk adjustment programs that fit best with assigned providers by implementing operational and clinical best practices in the risk adjustment methodology, understanding clinical suspects and appropriate clinical documentation and accurate coding. Candidate MUST live in AZ, CO or NM and work will require 50% travel.

Responsibilities

Key Role Objectives/Responsibilities

Provide direction and give guidance on coding best practices

Responsible for identifying the impact of documentation and coding on

Evaluate the element of the medical record for diagnosis code selection

Educate healthcare provider, coder and/or office staff about the risk adjustment model, documentation and coding

Improve the practice's documentation and coding accuracy and help the practice adopt more efficient and effective processes

Create a long-term, self-sustaining solution for the healthcare provider's practice

Assist healthcare providers to document accurately and code to the highest level of specificity in order to capture a member's true health status at the time of care

Query providers to obtain additional medical record documentation or to clarify documentation to ensure accurate and appropriate coding

Perform chart review and identify previously accepted/undocumented conditions to accurately report patient's true health status

Demonstrate analytical and problem-solving ability with regard to barriers in receiving and validating accurate HCC information, and be able to communicate findings clearly and concisely, orally and in writing

Take responsibility and ownership of coding projects as assigned. Work with other team members and ensure completion with appropriate speed and expected accuracy

Responsible for sharing knowledge of issues with supervising lead

Develop a comprehensive understanding of Humana's risk adjustment programs and the resources required for successful implementation

Develop and apply keen insight of our providers and our KPIs, and be able to strategically assess where improvements can be made in the most effective way with available resources

Perform analysis of performance indicators and puts together a formal presentation for reporting out to providers on a regularly scheduled basis

Provide measurable, actionable solutions to providers that will result in improved accuracy of documentation and coding, and adoption of best practices

Build a strong collaborative relationship with our internal partners to set the stage for successful engagement of our provider groups

Successfully implement identified course of action to effectively impact risk adjustment deadlines and report on progress regularly

Monitor KPIs through analytics and identify providers for Medicare Risk Adjustment training, programs and documentation/coding resources

Cultivate effective partnerships in a matrix environment of coding educators, medical director, clinical and market operations

Performs other relevant duties deemed necessary to achieve department and company-widegoals

Required Qualifications:

Must reside in CO, NM, or AZ

2 years coding review experience

Interpersonal skills

Effective communication, listening and professionalism

Problem-solving and team-building skills

Self-management, responsibility and accountability

Attention to detail

Strong analytical skills

Proficient in the use of MS Office

Knowledge of EMR for reviewing records

Experience in provider setting

CPC certification is required

We will require full COVID vaccination (https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated.html#vaccinated) for this job as we are a healthcare company committed to putting health and safety first for our members, patients, associates and the communities we serve.

If progressed to offer, you will be required to provide proof of full vaccination or documentation for a medical or religious exemption consideration where allowed by law. Requests for these exemptions should be submitted at least 2 week prior to your scheduled first day of work.

Certifications below is a plus:

CPCI (Certified Professional Coder-Instructor)

CPMA (Certified Professional Medical Auditor)

HIM (Health Information Management)

CCS (Certified Coding Specialist)

CCS-P (Certified Coding Specialist-Physician)

RHIT (Registered Health Information Technician)

RHIA (Registered Health Information Administrator)

Billing certification

Preferred Qualifications:

Bachelor's Degree

Additional Information

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com