Central California Alliance for Health · 21 hours ago
Risk Adjustment Coding Educator (Temporary)
United States
Full-time
Remote
Senior Level, Lead/Staff
$62/hr - $72/hr
8+ years expCentral California Alliance for Health is committed to providing accessible, quality health care guided by local innovation. They are seeking a Risk Adjustment Coding Educator who will act as a clinical coding subject matter expert, provide education to providers on clinical coding standards, and lead the Alliance Coding Workgroup.
GovernmentHealth CareHealth InsuranceHospital
Responsibilities
Acts as the clinical coding subject matter expert and lead coding resource across the organization
Acts as a resource and provides education to providers on clinical coding standards
Coordinates and leads the Alliance Coding Workgroup
Qualification
Required
Strong background in clinical coding and documentation education with current certification as a Registered Health Information Administrator (RHIA) and Certified Coding Specialist (CCS)
Demonstrated experience in supporting the development and implementation of clinical documentation improvement (CDI) programs
Excellent communication skills with the ability to clearly explain complex regulatory or clinical coding concepts to diverse audiences
Meticulous attention to detail with a strong foundation in auditing practices
Experience leading cross functional workgroups
Knowledge of medical coding languages, concepts, guidelines, methodologies, and regulations related to all sites of service, including knowledge of ICD-10, CPT, and HCPCS coding systems
Knowledge of principles and practices of training, including training content development for providers and staff
Knowledge of the relationship between diagnosis documentation and risk adjustment payment models
Knowledge of CMS Hierarchical Condition Categories (HCC) Risk Adjustment program, methodology, and impact to value-based contracts
Knowledge of principles and practices of internal data auditing
Knowledge of Electronic Medical Record (EMR) coding standards
Knowledge of Medicare and Medi-Cal coding policies
Knowledge of the principles and practices of conducting and responding to audits
Knowledge of the principles and practices of project management
Ability to act as a subject matter expert and technical resource and explain policies, regulations, terms, and procedures related to area of responsibility
Ability to accurately assign clinical codes and act as the final decision maker regarding clinical code assignments
Ability to conduct research, gather and interpret information and data, identify issues of concern, make logical recommendations for action, and present findings in a clear and organized manner
Ability to organize work, manage multiple tasks, establish priorities, adjust to changing priorities, and meet deadlines
Ability to interpret and apply policies, standards, and guidelines
Ability to make presentations and facilitate and lead meetings and workgroups
Ability to develop training materials and conduct internal and external training
Ability to foster effective working relationships and communicate clearly and effectively with external and internal stakeholders and individuals at all levels of the organization
Current certification as a Certified Coding Specialist (CCS) issued by the American Health Information Management Association and as a Certified Risk Adjustment Coder (CRC) issued by the American Academy of Professional Coders
Bachelor's degree in Health Care, Business, Nursing, or a related field
A minimum of eight years of experience including a minimum of three years of clinical experience and a minimum of eight years of risk adjustment coding experience which included provider education responsibilities (an Associate's degree and an additional two years of experience may substitute for the Bachelor's degree); or an equivalent combination of education and experience may be qualifying
Company
Central California Alliance for Health
The Alliance is a state-funded health plan that provides Medi-Cal insurance to Mariposa, Merced, Monterey, San Benito & Santa Cruz counties.
501-1000 employees
Funding
Current Stage
Late StageLeadership Team
Michael Schrader
Chief Executive Officer
Lisa Ba
Chief Financial Officer
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