Gather Health
Senior Manager of Risk Adjustment Coding
Gather Health, San Francisco, California, United States, 94199
Overview
Gather Health delivers Social Primary Care to older adults. Through our unique and differentiated care model and proprietary technology, Gather Health’s solution drives substantial care outcomes by addressing the whole person needs of their target demographic: dual eligible populations, the fastest growing government segment. To address the needs of these clinically and socially complex patients, Gather Health’s Social Primary Care solution is comprehensive and wholistic in nature, encompassing care and community within the four walls of Gather Health Centers and in the homes of its patients. This innovative approach leads to dramatically better outcomes for our patients and creates a more sustainable and equitable model for the healthcare system. We are looking for talented professionals to help us build the platform, scale our operations, and create generational health for communities across the country.
Responsibilities
Lead the Gather Disease Detection and Treatment (DDAT) program to ensure screening, documentation, and coding practices are aligned with CMS and organizational goals
Lead Gather coding team to ensure chart reviews (pre, concurrent, and post) are completed to ensure the most complete and accurate representation of patients’ health by identifying opportunities to improve accuracy of diagnoses documentation and coding
Participate in chart reviews as needed
Collaborate with providers and clinic staff regularly to provide observations and trends related to documentation and coding practices in the center
Provide education to providers and staff on topics related to compliant and accurate documentation and coding (e.g., CMS Medicare Risk Adjustment procedures and regulations, documentation guidelines, etc.)
Audit charts and consult providers on opportunities to improve documentation and coding practices
Support coding compliance audits as necessary
Support Revenue Cycle team with claims corrections and denials as needed
Maintain current knowledge of medical coding and HCC risk adjustment guidelines
Qualifications
4+ years working as a physician coder (including at least 2 years supporting risk adjustment coding)
Deep understanding of Medicare Risk Adjustment and compliance requirements
Risk Adjustment Coder credential (e.g., AAPC CRC, or similar)
Ability to work for any employer in the United States
Preferred skills and experience
Process improvement
Experience working with electronic health records (EHR) systems
Experience in a healthcare setting with a focus on quality improvement
Experience working with data analytics and reporting tools
Traits and characteristics
Strong interpersonal skills; in particular a track record of building effective working relationships with providers
Detail-oriented – demonstrates exceptional attention to detail in coding and documentation review
Proactive – actively identifies and addresses potential coding and compliance issues
Adaptable – able to effectively manage multiple tasks and adapt to changes in regulations and guidelines
Why join Gather Health
We are a mission-based organization that is passionate about changing the way seniors experience primary care
Our business model is unique and on the cutting-edge of the primary care industry
Our leadership team is comprised of experienced individuals who are committed to creating not only the best patient experience, but also an amazing employee experience for our colleagues
We are intentionally building a strong company culture and providing a compassionate and joyful work environment
The organization was conceptualized, founded, and launched by experienced co-founders with a track record of success in the healthcare space
Benefits
Generous PTO
Eleven Paid Holidays
Medical insurance coverage (health, dental, vision) with no waiting period for enrollment
Short and Long-Term disability insurance at no cost to you
Basic life insurance coverage at no cost to you
401K plan with 100% employer match, up to 4% of your salary
Supplemental benefits available
Gather Health is an Equal Opportunity Employer. All employment decisions are made without regard to age, race, creed, color, religion, sex, national origin, ancestry, disability status, veteran status, sexual orientation, gender identity or expression, genetic information, marital status, citizenship status, or any other basis as protected by federal, state, or local law.
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Gather Health delivers Social Primary Care to older adults. Through our unique and differentiated care model and proprietary technology, Gather Health’s solution drives substantial care outcomes by addressing the whole person needs of their target demographic: dual eligible populations, the fastest growing government segment. To address the needs of these clinically and socially complex patients, Gather Health’s Social Primary Care solution is comprehensive and wholistic in nature, encompassing care and community within the four walls of Gather Health Centers and in the homes of its patients. This innovative approach leads to dramatically better outcomes for our patients and creates a more sustainable and equitable model for the healthcare system. We are looking for talented professionals to help us build the platform, scale our operations, and create generational health for communities across the country.
Responsibilities
Lead the Gather Disease Detection and Treatment (DDAT) program to ensure screening, documentation, and coding practices are aligned with CMS and organizational goals
Lead Gather coding team to ensure chart reviews (pre, concurrent, and post) are completed to ensure the most complete and accurate representation of patients’ health by identifying opportunities to improve accuracy of diagnoses documentation and coding
Participate in chart reviews as needed
Collaborate with providers and clinic staff regularly to provide observations and trends related to documentation and coding practices in the center
Provide education to providers and staff on topics related to compliant and accurate documentation and coding (e.g., CMS Medicare Risk Adjustment procedures and regulations, documentation guidelines, etc.)
Audit charts and consult providers on opportunities to improve documentation and coding practices
Support coding compliance audits as necessary
Support Revenue Cycle team with claims corrections and denials as needed
Maintain current knowledge of medical coding and HCC risk adjustment guidelines
Qualifications
4+ years working as a physician coder (including at least 2 years supporting risk adjustment coding)
Deep understanding of Medicare Risk Adjustment and compliance requirements
Risk Adjustment Coder credential (e.g., AAPC CRC, or similar)
Ability to work for any employer in the United States
Preferred skills and experience
Process improvement
Experience working with electronic health records (EHR) systems
Experience in a healthcare setting with a focus on quality improvement
Experience working with data analytics and reporting tools
Traits and characteristics
Strong interpersonal skills; in particular a track record of building effective working relationships with providers
Detail-oriented – demonstrates exceptional attention to detail in coding and documentation review
Proactive – actively identifies and addresses potential coding and compliance issues
Adaptable – able to effectively manage multiple tasks and adapt to changes in regulations and guidelines
Why join Gather Health
We are a mission-based organization that is passionate about changing the way seniors experience primary care
Our business model is unique and on the cutting-edge of the primary care industry
Our leadership team is comprised of experienced individuals who are committed to creating not only the best patient experience, but also an amazing employee experience for our colleagues
We are intentionally building a strong company culture and providing a compassionate and joyful work environment
The organization was conceptualized, founded, and launched by experienced co-founders with a track record of success in the healthcare space
Benefits
Generous PTO
Eleven Paid Holidays
Medical insurance coverage (health, dental, vision) with no waiting period for enrollment
Short and Long-Term disability insurance at no cost to you
Basic life insurance coverage at no cost to you
401K plan with 100% employer match, up to 4% of your salary
Supplemental benefits available
Gather Health is an Equal Opportunity Employer. All employment decisions are made without regard to age, race, creed, color, religion, sex, national origin, ancestry, disability status, veteran status, sexual orientation, gender identity or expression, genetic information, marital status, citizenship status, or any other basis as protected by federal, state, or local law.
#J-18808-Ljbffr