Millennium Physician Group
Specialist III, Medical Coding Adjustment (remote)
Millennium Physician Group, Fort Myers, Florida, United States, 33916
Specialist III, Medical Coding Adjustment (Remote)
The Medical Coding Adjustment Specialist III is responsible for reviewing provider responses to suspected conditions and validating these responses against the entire patient medical record. This role will leverage existing EHR tools and other technologies to validate the completeness and documented clinical support of provider responses. This role aims to ensure all chronic conditions impacting the patient are addressed by the provider, present in the medical record, appropriately supported through documentation, and accurately represent the health status of the patient to the highest degree of specificity. Responsibilities include: acting as a preceptor to new employees during the orientation process, optimizing our billing processes, maintaining compliance, and educating providers in a visually engaging way, analyzing and auditing findings to identify areas for improvement in provider documentation practices, maintaining active professional certification and complying with all educational, professional, and ethical requirements of said certification, demonstrating knowledge of health systems operations, including an understanding of reimbursement methodologies and coding conventions, demonstrating ability to perform accurate and complete chart reviews for Hierarchical Condition Categories (HCC)/Risk Adjustment, advanced knowledge and understanding of HCC/Risk Adjustment coding and documentation requirements, conducting medical record reviews to evaluate documentation to ensure that diagnosis coding meets specificity requirements to support clinical indicators, monitoring reviews for potential risks to the organization and escalating as needed to the leadership team, occasionally leading workgroups and managing project deliverables for department initiatives, audits, and provider communications, providing written or oral recommendations to department leadership related to process improvements, root-cause analysis, and/or barrier resolution applicable to Risk Adjustment initiatives, demonstrating ability to identify and communicate trends in provider coding and documentation, providing feedback to the direct supervisor of concerns and underperforming providers, coordinating with provider education team to assist educational efforts, possessing excellent written, verbal, communication, and attention to detail skills, collaborating and working in tandem with other members of the MRA Department, demonstrating excellent guest service to internal team members and patients, and performing other related duties as assigned. Qualifications include: high school diploma or GED equivalent, 2+ years of experience in a payer or healthcare-related field, 3+ years of HCC Coding experience, certified procedural coder (CPC), CRC designation preferred, certified documentation expert outpatient (CDEO), or AAPC or AHIMA approved coding credential, proficiency in 10-key, Word, and Excel, maintaining active professional certification and adhering to all industry educational, professional, regulations, and ethical requirements, organizational skills with a focus on tracking patient care and improving patient flow, proven knowledge of compliance and up-to-date guidelines regarding applicable coding and documentation, understanding and complying with policies and procedures for confidentiality of all patient records, HIPAA, and security of systems, ability to maintain a consistent accuracy rate of 95% or above, ability to meet productivity standards established by leadership, and ability to work independently in a fast-paced, cross-functional environment. Benefits include: 3 weeks PTO & 7 paid holidays, medical, dental, vision, employer paid basic life & short term disability coverage (goes into effect after 1 year of full-time employment), 401(k) with match, employee wellness, other employee discount programs like tickets at work and cell phone discounts, dependent care FSA, voluntary life, long term disability, critical illness, pet insurance, and more. Why Millennium? Millennium Physician Group is one of the largest comprehensive primary care practices with healthcare providers throughout Florida. At Millennium Physician Group, you will find an organization that focuses on family and building a strong network of people to care for the communities we serve. We are always searching for employees who have a strong customer service attitude, fantastic teamwork skills and a willing smile ready to share. Our promise is to provide you with the tools to do your job successfully, as well as providing a team atmosphere that empowers you to seek better ways to deliver care to our patients and their families. We also promise to care for you as an individual, and help you grow in your role with Millennium Physician Group. If you are interested in joining an organization that puts an emphasis on teamwork and family, then Millennium Physician Group is the right choice.
The Medical Coding Adjustment Specialist III is responsible for reviewing provider responses to suspected conditions and validating these responses against the entire patient medical record. This role will leverage existing EHR tools and other technologies to validate the completeness and documented clinical support of provider responses. This role aims to ensure all chronic conditions impacting the patient are addressed by the provider, present in the medical record, appropriately supported through documentation, and accurately represent the health status of the patient to the highest degree of specificity. Responsibilities include: acting as a preceptor to new employees during the orientation process, optimizing our billing processes, maintaining compliance, and educating providers in a visually engaging way, analyzing and auditing findings to identify areas for improvement in provider documentation practices, maintaining active professional certification and complying with all educational, professional, and ethical requirements of said certification, demonstrating knowledge of health systems operations, including an understanding of reimbursement methodologies and coding conventions, demonstrating ability to perform accurate and complete chart reviews for Hierarchical Condition Categories (HCC)/Risk Adjustment, advanced knowledge and understanding of HCC/Risk Adjustment coding and documentation requirements, conducting medical record reviews to evaluate documentation to ensure that diagnosis coding meets specificity requirements to support clinical indicators, monitoring reviews for potential risks to the organization and escalating as needed to the leadership team, occasionally leading workgroups and managing project deliverables for department initiatives, audits, and provider communications, providing written or oral recommendations to department leadership related to process improvements, root-cause analysis, and/or barrier resolution applicable to Risk Adjustment initiatives, demonstrating ability to identify and communicate trends in provider coding and documentation, providing feedback to the direct supervisor of concerns and underperforming providers, coordinating with provider education team to assist educational efforts, possessing excellent written, verbal, communication, and attention to detail skills, collaborating and working in tandem with other members of the MRA Department, demonstrating excellent guest service to internal team members and patients, and performing other related duties as assigned. Qualifications include: high school diploma or GED equivalent, 2+ years of experience in a payer or healthcare-related field, 3+ years of HCC Coding experience, certified procedural coder (CPC), CRC designation preferred, certified documentation expert outpatient (CDEO), or AAPC or AHIMA approved coding credential, proficiency in 10-key, Word, and Excel, maintaining active professional certification and adhering to all industry educational, professional, regulations, and ethical requirements, organizational skills with a focus on tracking patient care and improving patient flow, proven knowledge of compliance and up-to-date guidelines regarding applicable coding and documentation, understanding and complying with policies and procedures for confidentiality of all patient records, HIPAA, and security of systems, ability to maintain a consistent accuracy rate of 95% or above, ability to meet productivity standards established by leadership, and ability to work independently in a fast-paced, cross-functional environment. Benefits include: 3 weeks PTO & 7 paid holidays, medical, dental, vision, employer paid basic life & short term disability coverage (goes into effect after 1 year of full-time employment), 401(k) with match, employee wellness, other employee discount programs like tickets at work and cell phone discounts, dependent care FSA, voluntary life, long term disability, critical illness, pet insurance, and more. Why Millennium? Millennium Physician Group is one of the largest comprehensive primary care practices with healthcare providers throughout Florida. At Millennium Physician Group, you will find an organization that focuses on family and building a strong network of people to care for the communities we serve. We are always searching for employees who have a strong customer service attitude, fantastic teamwork skills and a willing smile ready to share. Our promise is to provide you with the tools to do your job successfully, as well as providing a team atmosphere that empowers you to seek better ways to deliver care to our patients and their families. We also promise to care for you as an individual, and help you grow in your role with Millennium Physician Group. If you are interested in joining an organization that puts an emphasis on teamwork and family, then Millennium Physician Group is the right choice.