Risk Adjustment Coding and Documentation Specialist - remote eligible

About the job

Kootenai Health in Coeur d'Alene is hiring a full-time Risk Adjustment Coding and Documentation Specialist for the Kootenai Care Network (KCN); the job is eligible for remote work, with some states excluded. The specialist helps network practices improve the quality, completeness and accuracy of their clinical diagnosis coding and documentation.

Kootenai Health serves patients across northern Idaho and the Inland Northwest.

What you'll do

• Verify that diagnosis codes for risk adjustment and the clinical documentation behind them are accurate, complete, specific and appropriate to the services provided
• Support and teach KCN clinicians and their staff on pre-visit planning, including identifying how severe a patient's illness is
• Give KCN clinicians and their staff regular feedback on coded cases and on chances to improve documentation
• Review chart documentation on the patient's clinical status, current treatment plan and past medical history, and identify possible gaps in provider documentation
• Act as a resource, independently educating KCN clinicians and staff about errors and issues in diagnosis coding and documentation
• Create training materials and program improvement plans, and suggest and teach solutions that follow nationally recognized coding guidelines
• Work with payer partners on coding recapture and on resolving diagnoses
• Collect, track and share diagnosis coding information using software and a population health application
• Partner with the KCN Contracting, Analytics and Information System teams to choose interventions for performance opportunities, such as improving data, reports and the population health application
• Use experience and judgment to plan work and reach goals

What you need

• At least 3 years of coding or medical record chart review experience in a health care setting
• Previous experience with risk adjustment methodology and diagnosis coding
• A coding certification through AHIMA or AAPC: for outpatient coding, Certified Coding Specialist (CCS), Certified Professional Coder (CPC), Certified Coding Specialist-Physician (CCS-P) or another related certification
• CDEO (Clinical Documentations Expert Outpatient) certification within 12 months of hire
• Strong knowledge of medical record documentation and of CPT and ICD-10 coding
• A track record of managing projects or coordinating detailed projects or activities
• Strong written and verbal communication skills and the ability to establish and build strong working relationships
• Able to lift and move up to 10 pounds, work seated, use typical office equipment and make repetitive movements
• Kootenai Health employees can't currently be located in California, Hawaii, Massachusetts and Minnesota; Montana, Nebraska, Nevada and New Hampshire; New Jersey, New Mexico, New York and North Dakota; Rhode Island, Vermont and Washington D.C.; or West Virginia and Wyoming (the list may change)

Preferred

• Graduation from a formal coding program, or a completed coding training course
• An associate degree
• Certification as a risk adjustment coder
• Experience with the Hierarchical Coding Category (HCC) Risk Adjustment Model
• Familiarity with HCC diagnosis coding and the clinical record review process

Schedule

• Day shift, full-time
• 80 hours per two-week pay period
• Remote eligible, with travel to the main campus in Coeur d'Alene about 2 to 4 times a year

Benefits

• Medical coverage starting the first of the month after 30 days of employment, including plans fully paid by the employer for eligible full-time employees
• Dental, vision, life and pet insurance, plus telemedicine and wellbeing resources
• Tuition assistance after 90 days
• Retirement plans (pre-tax and Roth) with an employer match of 3% to 6%
• Night, weekend and PRN shift differentials
• A wellness program with coaching and financial wellness resources, plus free or discounted fitness centers and wellbeing apps
• Employee discounts and an employee referral bonus program