Risk Adjustment Coder

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🕒 6 days ago

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Boston Medical Center (BMC)

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

Founded 1996

Boston Medical Center (BMC) is a 511-bed, equity-led academic medical center and a proud member of the Boston Medical Center Health System. BMC delivers a model of healthcare where innovative and equitable care empowers all patients to thrive. As a premier academic medical center in Boston, a national leader in clinical care, and the largest essential hospital in New England, BMC’s world-class clinicians provide comprehensive care in more than 70 specialties and subspecialties.

📋 Description

• Determine the appropriate ICD10-CM diagnoses codes based on clinical documentation • Review retrospective medical record documentation • Ensure that the codes are appropriately assigned • Collaborate with nursing or coding staff on retrospective medical record review for severity, accuracy, and quality issues • Create and analyze reports for coding improvement trending and high-level dashboards for ongoing monitoring and opportunities • Provide ongoing feedback to physicians and other providers regarding coding guidelines and requirements • Assist with educational in-services for physicians and other providers regarding coding and documentation compliance as well as new policies and procedures related to billing. • Participate in training new coding staff, as needed.

🎯 Requirements

• High school diploma or equivalent medical coding education • Coding Certification from American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) is required • Certification may include Certified Risk Adjustment Coder (CRC) or Certified Professional Coder (CPC) and/or Certified Clinical Documentation Specialist- Outpatient or Certified Documentation Expert Outpatient (CDEO) • Certified Coding Specialist (CCS), or Certified Coding Specialist Physician-Based (CCS-P), or a Certified Coding Associate (CCA), or Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA) required • Minimum of two (2) years progressive coding experience in multiple specialties, HCC Risk adjustment Coding • Experience with an Electronic Medical Record (EMR), EPIC preferred • Knowledge of AHA coding guidelines and methodologies: HCC’s and other RA methodologies, ICD-10-CM coding guidelines, Office of Inspector General (OIG) and Federal and State regulations • Extensive knowledge of medical terminology, anatomy, and pathophysiology, pharmacology, and ancillary test results • Strong organization and analytical thinking skills – detail oriented • Proficient with Microsoft Office applications (Outlook, Word, Excel) • Medical Record audits and review • Familiarity with the external reporting aspects of healthcare • Familiarity with the business aspects of healthcare, including prospective payment systems.

🏖️ Benefits

• Medical • Dental • Vision • Pharmacy • Flexible Spending Accounts • 403(b) savings matches • Paid time off • Career advancement opportunities • Resources to support employee and family well-being