Central California Alliance for Health · 18 hours ago
Clinical Coding Educator (Temporary)
United States
Full-time
Remote
Senior Level, Lead/Staff
8+ years expCentral California Alliance for Health is committed to providing accessible, quality health care guided by local innovation. They are seeking a Clinical Coding Educator to act as a subject matter expert in clinical coding, provide education to providers, 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 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 Medicare and Medi-Cal coding policies
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 make presentations and facilitate and lead meetings and workgroups
Current unrestricted license as a Registered Nurse or Licensed Vocational Nurse issued by the State of California
Current certification as a Registered Health Information Administrator (RHIA) and Certified Coding Specialist (CCS) issued by the American Health Information Management Association
Bachelor's degree in Nursing, Health Care, or a related field
A minimum of eight years of experience including a minimum of three years of clinical experience and a minimum of five years of CDI (clinical documentation integrity) experience with emphasis on Medi-Cal and Medicare requirements in a managed care environment 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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