1+ months

Coding Educator 2 - Phoenix, AZ or Centennial CO

Humana
Centennial, CO 80111
Description Our search is focused on identifying a certified coder who will primarily be responsible for conducting prospective and concurrent reviews to identify documentation improvement opportunities according to CMS and ICD-10 risk adjustment coding guidelines. In this role you will be working collaboratively with providers, coder, and/or office staff performing coding and review onsite. Part of the job will be also taking ownership of Medicare risk adjustment programs that fit best with assigned providers by implementing operational and clinical best practices in the risk adjustment methodology, understanding clinical suspects and appropriate clinical documentation and accurate coding. Work will require 50% travel. Responsibilities Key Role Objectives/Responsibilities + Provide direction and give guidance on coding best practices + Responsible for identifying the impact of documentation and coding on + Evaluate the element of the medical record for diagnosis code selection + Educate healthcare provider, coder and/or office staff about the risk adjustment model, documentation and coding + Improve the practices documentation and coding accuracy and help the practice adopt more efficient and effective processes + Create a long-term, self-sustaining solution for the healthcare providers practice + Assist healthcare providers to document accurately and code to the highest level of specificity in order to capture a members true health status at the time of care + Query providers to obtain additional medical record documentation or to clarify documentation to ensure accurate and appropriate coding + Perform chart review and identify previously accepted/undocumented conditions to accurately report patients true health status + Demonstrate analytical and problem-solving ability with regard to barriers in receiving and validating accurate HCC information, and be able to communicate findings clearly and concisely, orally and in writing + Take responsibility and ownership of coding projects as assigned. Work with other team members and ensure completion with appropriate speed and expected accuracy + Responsible for sharing knowledge of issues with supervising lead + Develop a comprehensive understanding of Humanas risk adjustment programs and the resources required for successful implementation + Develop and apply keen insight of our providers and our KPIs, and be able to strategically assess where improvements can be made in the most effective way with available resources + Perform analysis of performance indicators and puts together a formal presentation for reporting out to providers on a regularly scheduled basis + Provide measurable, actionable solutions to providers that will result in improved accuracy of documentation and coding, and adoption of best practices + Build a strong collaborative relationship with our internal partners to set the stage for successful engagement of our provider groups + Successfully implement identified course of action to effectively impact risk adjustment deadlines and report on progress regularly + Monitor KPIs through analytics and identify providers for Medicare Risk Adjustment training, programs and documentation/coding resources + Cultivate effective partnerships in a matrix environment of coding educators, medical director, clinical and market operations + Performs other relevant duties deemed necessary to achieve department and company-wide goals Required Qualifications + Qualifications/Role Essentials + Minimum of 2 years coding review experience + Interpersonal skills + Effective communication, listening and professionalism + Problem-solving and team-building skills + Self-management, responsibility and accountability + Attention to detail + Strong analytical skills + Proficient in the use of MS Office + Knowledge of EMR for reviewing records + Experience in provider setting + CPC certification is required + Certifications below is a plus: + CPCI (Certified Professional Coder-Instructor) + CPMA (Certified Professional Medical Auditor) + HIM (Health Information Management) + CCS (Certified Coding Specialist) + CCS-P (Certified Coding Specialist-Physician) + RHIT (Registered Health Information Technician) + RHIA (Registered Health Information Administrator) + Billing certification Preferred Qualifications + Bachelor's Degree Additional Information Candidate must live within commuting distance to Phoenix AZ or Centennial CO offices. Scheduled Weekly Hours 40 About Us Mission: At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms when and where they need it. Our employees are at the heart of making this happen and thats why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first. Equal Opportunity Employer It is our policy to recruit, hire, train, and promote people without regard to race, color, religion, sex, national origin, age, sexual orientation, gender identity or expression, disability, or veteran status, except where age, sex, or physical status is a bona fide occupational qualification. View the EEO is the Law poster. If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, or are limited in the ability or unable to access or use this online application process and need an alternative method for applying, you may contact mailbox_tas_recruit@humana.com for assistance. Humana Safety and Security Humana will never ask, nor require a candidate provide money for work equipment and network access during the application process. If you become aware of any instances where you as a candidate are asked to provide information and do not believe it is a legitimate request from Humana or affiliate, please contact mailbox_tas_recruit@humana.com to validate the request. <>

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Posted: 2020-02-05 Expires: 2020-04-05

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Coding Educator 2 - Phoenix, AZ or Centennial CO

Humana
Centennial, CO 80111

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