HCC Coder

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CAROUSEL

_PARAGRAPH JOB_DESCRIPTION.SHARE.HTML Midland, Michigan Business Professional 7:00 a.m. to 3:30 p.m. Monday - Friday Regular Full-Time Day Shift Professional Coding/Billing 45935 Job Description Summary •Candidates must have a primary address located within the state of Michigan or willing to move to Michigan to be considered.•Travel to provider office location/offices for HCC education as determined by manager Mandatory on-site team meetings in Midland 1 x per month To be part of our organization, every employee should understand and share in the MyMichigan Health Vision, support our Mission, and live our Values. These values include excellence, integrity, teamwork, and accountability - must guide what we do, as individuals and professionals. The HCC Coder, working under the direction of the Clinical Documentation Integrity Manager, utilizes coding expertise to identify areas of opportunity that impacts the quality and the completeness of the medical record documentation. Through prospective, concurrent, and retrospective evaluation of the medical record documentation, the HCC Coder will be responsible for working collaboratively with the clinical team members to support the capture of Hierarchical Condition Categories (HCCs) and

ICD-10-CM

specificity of ambulatory visits. The HCC Coder utilizes knowledge of coding guidelines, coding/billing compliant practices, HCCs, and clinical knowledge to identify opportunities to capture chronic conditions that affect the patient's health status and predict future health care costs. Responsibilities (25%) Uses established technology to accurately process HCC opportunities utilizing claims and clinical data to facilitate Provider HCC capture during the patient encounter. (25%) Consistently maintains quality and productivity standards to include daily opportunity review targets. (25%) Participates in orientation and training of new and established providers in the documentation HCC capture utilizing established technology. Educates medical staff on compliant HCC captures and RAF score optimization. Participates, as needed, in providing 1:1 and/or group education to clinical team members and/or colleagues in the utilization of software to facilitate HCC capture to positively impact Risk Adjustment Factor (RAF) scores (25%) Understands risk adjusted payment methodologies, HCC assignment and payment methodology, professional coding and billing, outpatient facility coding and billing, APC assignment, and OPPS reimbursement methodology and shares this knowledge with colleagues and clinical team members.

Other Duties and Responsibilities:

Leads efforts to evaluate HCC documentation and provides recommendations to improve documentation and coding. Leads and/or actively participates in meetings. Actively participates in department performance improvement and employee engagement activities. Performs all other duties or special projects requested by coding leadership and proactively communicates any problems that arise to maintain a smooth operation of the department. Exhibits enthusiasm for the profession, embraces educational opportunities and department support offered and remains engaged in the goals and the vision of the department. Role models the professional standards of behavior and encourages all staff to do the same. MyMichigan Health is a technology driven organization and employees need to demonstrate competency in Microsoft Windows. An employee may be required to participate in further learning opportunities offered by MyMichigan Health. Certifications and Licensures

E/M CODER

CPC, CCS, CCSP, RHIT, OR RHIA One of the following certifications are required: Certified Professional Coding (CPC) certificate or Certified Coding Specialist Physician Office (CCS-P) certificate required. Registered Health Information Technician (RHIT) or Registered Health Information Technician preferred. Required Education High school diploma or GED is required

Other Information Experience, Training and Skills:

Four (4) years' experience in the medical field preferred. Two (2) years physician coding and billing experience preferred. One (1) year with direct physician contact preferred. Strong interpersonal, written, and communication skills required. Being an effective educator, self-start er , and highly organized is required. Ability to exercise initiative and judgment is required. Knowledge of terminology and anatomy. Knowledge of Word, Excel, and PowerPoint is preferred.

Physical/Mental Requirements and Typical Working Conditions:

Exposure to stressful situations Able to wear personal protective equipment that includes latex materials or appropriate substitute if required for your position. Is able to move freely about the facility with or without an assisted device and must be able to perform the functions of the job as outlined in the job description. Overall vision and hearing are necessary with or without assisted device(s). Frequently required to sit/stand/walk for long periods of time. Some exposure to blood borne pathogens and other potentially infectious material. Must follow MyMichigan Health bloodborne pathogen and TB testing as required. Ability to handle multiple tasks, get along with others, work independently, regular and predictable attendance and ability to stay awake. Overall dexterity is required including handling, reaching, grasping, fingering, and feeing. May require repetition of these movements on a regular to frequent basis.

Physical Demand Level:

Sedentary. Must be able to occasionally (0-33% of the workday) lift or carry 0-10 lbs. Apply JOB_DESCRIPTION.SHARE.HTML

CAROUSEL

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