Coding and Documentation Specialist

This position is responsible for identifying and promoting accurate coding and documentation of providers participating with Torrance Health IPA and Torrance Memorial Integrated Physicians, LLC. This position will help facilitate clinical chart review and summarize its findings. There may be other duties assigned to meet the department needs.

PRIMARY DUTIES AND RESPONSIBILITIES

• Reports on the accuracy and consistency of clinical and coding data in accordance with accepted and established standards of risk adjustment coding and documentation.
• Requires knowledge of

ICD-10-CM

coding guidelines and HCC methodologies.

• Supports accurate risk adjustment code capture by reviewing clinical documentation.
• Develops and monitors group-specific coding and documentation improvement plans for provider partners.
• Performs chart reviews focused on identifying missed diagnoses in all applicable health care settings.
• Performs independent audits of physician records to improve coding accuracy.
• Develops educational tools for improved accuracy of coding and documentation.
• Provides input and expertise for coding best practices.

KNOWLEDGE, SKILLS, & EXPERIENCE REQUIRED

• Minimum of high school diploma or equivalent.
• Current Certified Professional Coder Apprentice (CPC-A) (Note - A commitment to continued employment with our organization for one year after apprentice term completion required), Certified Professional Coder (CPC), and/or Certified Coding Specialist (CCS).
• Familiarity with ICD-10-CM, CPT, and HCPCS coding, with emphasis on diagnosis coding.
• Familiarity with HIPAA regulations involving protected health information and technical safeguards.
• Able to implement quality assurance audits and communicate results effectively.
• Demonstrates effective written and verbal communication, interpersonal skills and organizational skills.
• At least one year of related healthcare and/or managed care experience.
• Ability to travel to clinics throughout South Bay area and work on site at least one day a week.
• Demonstrates proficiency in data analysis, data interpretation and identifying and resolving issues.
• Familiarity with common electronic medical record applications such as Cerner.
• Basic understanding of project management methodologies and key terms.
• Proficient in Microsoft Office (intermediate Excel, Word, PowerPoint, OneDrive, SharePoint, Outlook, and Teams) and basic computer functions including file management.
• Must have excellent time management skills and be highly organized and self-motivated.
• Maintain a high level of productivity and confidentiality.
• Excellent customer service, problem solving skills and attention to detail.
• The ability to follow-through in a timely fashion on tasks is essential.
• Possess excellent written, verbal, and interpersonal communication skills.
• Team-oriented and leadership skills.
• Must possess initiative; tact; poise; neat personal appearance; physical condition commensurate with the requirements of the position.
• A valid driver's license and insurance/liability policy in the employee's name is mandatory in applicable cities/states when a motor vehicle is necessary for the position.

Management will notify such employees when applicable.

KNOWLEDGE, SKILLS, & EXPERIENCE PREFERRED

• Certified Risk Adjustment Coder (CRC) credential from AAPC
• Experience providing physician education in one-on-one, group, and virtual settings
• Previous Medicare Risk Adjustment experience
• Exposure to the use of data analytics applications and reporting such as Tableau.
• Associate degree or higher in health science, business administration, computer science, or other related field

Job Type:

Full-time Pay:

$25.00 - $35.46 per hour

Benefits:

Dental insurance Employee assistance program Flexible spending account Health insurance Life insurance Paid time off Vision insurance

Work Location:

Hybrid remote in Torrance, CA 90505