
Coder
- Bakersfield, CA
- Permanent
- Full-time
- Review patient medical record information via population health tools on both a retroactive and prospective basis to identify, assess, monitor and review network coding opportunities as it pertains to risk adjustment.
- Ensure that the diagnosis codes for each chronic or major medical condition have been captured and work to educate providers on opportunities to improve documentation on medical conditions.
- Review clinical documentation across the network to identify patterns and trends in clinical documentation. Work with network providers to improve clinical documentation to better support CMS Risk Adjustment guidelines.
- Develop education materials and tools to help network providers improve clinical documentation and support Hierarchical Condition Category coding capture.
- Participate network performance improvement initiatives.
- Safeguards medical records and preserves the confidentiality of personal health information through the observance of physician network policies pertinent to the release of medical record information, record retention, and HIPAA privacy and security. Qualifications:Minimum Qualifications:- Associates degree or equivalent work experience
- CPC,CCS, CCS-P, or RHIT
- Advanced knowledge of CPT and ICD-10 coding
- Knowledge of federal and state guidelines on all coding systems and sponsored programs.
- Familiarity and understanding of CMS HCC Risk Adjustment coding and data validation requirements.
- Must possess the ability to work independently with strong organizational, communication and interpersonal skills to support the management of multiple priorities, at multiple practice locations, with significant attention to detail for completion of both verbal and written external communications.
- Computer literacy of medical information system, records management software, encoders.
- Must have excellent verbal communication skills.
- Proficiency in MS office (Outlook, Excel, Word).Preferred Qualifications:- 2-3 years of experience in outpatient coding preferred
- CRC, in addition to certifications listed above, desired