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HCC Coding Specialist Population Health, Full Time - Day

Company: St. Luke's of Kansas City
Location: Kansas City
Posted on: November 22, 2021

Job Description:

Job Description

We are hiring a HCC Coding Specialist with Population Health! This is a Monday through Friday day shift position based out of our Corporate Offices.

The Opportunity:

Saint Luke's Health System's Population Health team is seeking a Hierarchical Condition Category Coder (HCC) to assist healthcare providers in identifying and resolving issues related to incomplete or missing clinical documentation. You will have the opportunity to work with payors on outliers, trending, analysis for improvement opportunities, and strategies. The HCC Coding Specialist will work under minimal direction, independently and diligently reviewing clinical documentation and diagnostic results as appropriate to validate and ensure correct procedural and diagnostic coding of professional service rendered by clinicians, are in accord with documentation and coding guidelines for all patient services, such as: inpatient, outpatient, ambulatory clinic, primary care, behavioral health, surgical and specialty clinics.

Shift Details: Monday through Friday

The Work:

* Ensures compliance with all applicable Federal, State and/or County laws and regulations related to coding and documentation guidelines for Risk Adjustment.
* Reviews medical records, patient medical history and physical exams, physician orders, progress notes, consultation reports, diagnostic reports, operative and pathology reports, and discharge summaries
* Reviews all medical record documentation using the Healthcare Effectiveness Data and Information Set (HEDIS)
* Support physicians and APPs by providing education on documentation and coding as it relates to risk adjustment coding and population health strategies
* ICD-10-CM Coding review
* Performs 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
* Communicates and coordinates reviews with physician office staff and distributes correspondence related to review
* Educates and advises staff on proper code selection, documentation guidelines as well as assist with training and education for new hires
* Identifies training needs; prepares summary reports and conducts coaching as appropriate for clinicians and other staff to improve the quality of the documentation to reflect members' health data.
* Conducts audits to abstract data not submitted by providers

A minimum of 1 year HCC specific Coding required

Successful completion of a coding certificate program: CPC, CPC-H from AAPC or CCS-P, CCS from AHIMA. Initial demonstration and maintenance of continuing education/membership is required.

Certified Auditor (CPMA/CEMA) required.

CRC preferred

We are seeking someone with advanced understanding of medical terminology, pharmacology, body systems/anatomy, physiology and concepts of disease processes.

The ideal candidate will have demonstrated ability to utilize a variety of electronic medical records systems. To be successful in this role you must have the ability to manage significant workload and work efficiently under pressure meeting established deadlines with minimal supervision. We are seeking someone with strong time management skills. You must possess high degree of accuracy, efficiency and dependability and have excellent written and oral communication for representation of clear and concise results.

Why Saint Luke's?:

* Saint Luke's offers competitive salaries and benefits packages to all of their employees, click here to find out more.
* We believe in creating a collaborative environment where all voices are heard.
* We are here for you and will support you in achieving your goals.
* We are dedicated to innovation and always looking for ways to improve.

Job Requirements

Applicable Experience:

3-5 years

Cert Professional Coder - Various

Bachelor's Degree (Required)

Job Details

Full Time

Day (United States of America)

"The best place to get care. The best place to give care." That is the Saint Luke's vision and, whether in a hospital, clinic, practice, or office, our more than 12,000 employees strive toward that vision every day. Saint Luke's employees are proud of our rich history and heritage, and that we remain the only faith-based, nonprofit, locally owned health system in Kansas City. Joining Saint Luke's means joining a team of exceptional professionals who always strive for excellence in patient care. Take this opportunity to do the best work of your career within a highly diverse and inclusive work space where all voices matter.

Join the Kansas City region's premiere provider of health services. Equal Opportunity Employer. We hire only non-tobacco users.

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.

Keywords: St. Luke's of Kansas City, Kansas City , HCC Coding Specialist Population Health, Full Time - Day, Healthcare , Kansas City, Kansas

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