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Population Health Coding Analyst, Full Time.

Home Visits-KCMO, .

JobReq0031979

 

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Population Health Coding Analyst

  • Home Visits-KCMO, United States, 64131
  • HIM
  • Full Time

Job Description​

The Population Health Coding Analyst under minimal direction, independently and diligently reviews and supports the capture of correct coding including documentation improvement, provider education, analyzing reports, and identifying process improvements with an emphasis on Risk Adjustment and Quality Measure (CPTII) coding. The Coding Analyst will assist healthcare providers in identifying and resolving issues related to incomplete or missing clinical documentation.  The Coding Analyst will also work with payors on outliers, trending, analysis for improvement opportunities and strategies.

Bachelor's Degree or 5+ years experience in lieu of required.

3-5 years of general medical coding experience required.

3-5 years of auditing experience and provider education required.

A minimum of 1 year HCC specific coding required.

CPC, CCS-P or CCS required.

CMPA, CEMA or CPCO required.

  • Ensure compliance with all applicable Federal, State and/or County laws and regulations related to coding and documentation guidelines with an emphasis on Risk Adjustment.

  • Support physicians and APPs by providing education on documentation and coding as it relates to risk adjustment coding and population health strategies.

  • Provide feedback that will assist Population Health team with reporting valid HEDIS measures including CPTII coding with the goal of ensuring accurate, reliable, and publicly reportable data.

  • Review medical records, patient medical history and physical exams, physician orders, progress notes, consultation reports, diagnostic reports, operative and pathology reports, and discharge summaries.

  • Verify diagnosis codes are supported by the documentation and ensure with ICD-10-CM Guidelines for Coding and Reporting.

  • Verify diagnosis codes for each chronic or major medical condition have been captured and submitted within the permitted timeframe.

  • Verify any diagnosis code that is unsubstantiated by the record is eliminated.

  • Review for clinical indicators and query providers to capture the severity of illness of the patient.

  • Perform on-site or electronic clinical validation audits and interpretation of medical documentation to ensure capture of all relevant coding based on CMS Hierarchical Condition Categories (HCC) conditions that are applicable to Medicare Risk Adjustment and Managed Care Contract reimbursement initiatives.

  • Communicate and coordinate reviews with physician office staff and distribute correspondence related to review.

  • Educate and advise staff on proper code selection, documentation guidelines as well as assist with training and education for new hires.

  • Identify training needs; prepare summary reports and conduct coaching as appropriate for clinicians and other staff to improve the quality of the documentation to reflect members’ health data.

  • Conduct audits to abstract data not submitted by providers.

  • Perform other duties as assigned.

Job Requirements

Applicable Experience:

3-5 years

Certified Risk Adjustment Coder - American Academy of Professional Coders (AAPC), Cert Professional Coder - American Academy of Professional Coders (AAPC), Cert Professional Medical Auditor - American Academy of Professional Coders (AAPC)

Bachelor's Degree

Job Details

Full Time

Day (United States of America)

The best place to get care. The best place to give care. Saint Luke’s 12,000 employees strive toward that vision every day. Our employees are proud to work for the only faith-based, nonprofit, locally owned health system in Kansas City. Joining Saint Luke’s means joining a team of exceptional professionals who strive for excellence in patient care. Do the best work of your career within a highly diverse and inclusive workspace where all voices matter.

Join the Kansas City region's premiere provider of health services. Equal Opportunity Employer.

Effective November 1st, 2021, full COVID-19 vaccination is a condition of employment for all Saint Luke’s Health System employees unless a medical or religious exemption is approved.

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