• Value Based Coder

    Job ID
    2019-71405
    Employment Type
    Full Time
    Department
    Clinical Integration
    Hours / Pay Period
    80
    Facility
    Dignity Health Management Services Organization
    Shift
    Day
    Location
    Phoenix
    State/Province
    AZ
    Standard Hours
    Monday - Friday (8:00 AM - 5:00 PM)
    Work Schedule
    8 Hour
  • Overview

    The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric, full-service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Health’s Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, health plans and employers with a business objective to excel in coordinating patient care in a manner that supports containing costs while continually improving quality of care and levels of service. Dignity Health MSO accomplishes this by capitalizing on industry-leading technology and integrated administrative systems powered by local human resources that put patient care first.

    What We Offer

     Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art, flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options, including medical, dental and vision plans, for the employee and their dependents, Health Spending Account (HSA), Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave.

     

    • This position will report to the: Director Practice Transformation
    • Percentage Travel Required/Frequency: No Travel
    • FLSA Status: Non-Exempt
    • Remote Worker: Non-eligible

     

    Responsibilities

    What You’ll be Responsible For in this Role – Your Contribution & Career Journey

    Arizona Care Network (ACN) is a clinically integrated physician network and is a Dignity Health and Abrazo Health (Tenet) physician collaboration. The Value Based Coder is an employee of Inland Health Organization of Southern California, Inc., doing business as Dignity Health Managed Services Organization, a physician support organization owned by Dignity Health.

     

    As a member of the Clinical Performance team, the Value Based Coder works with providers and office staff across the network to identify opportunities for improved quality, risk adjustment coding performance. The Value Based Coder is a valuable resource in process improvement and identifying clinically appropriate risk adjusting conditions to capture.

     

    What We’re Looking For

    • Review patient medical record information via population health tools on both a retroactive and prospective basis to identify, assess, monitor and review network coding opportunities  as it pertains to risk adjustment
    • Ensure that the diagnosis codes for each chronic or major medical condition have been captured and work to educate providers on opportunities to improve documentation on medical conditions.
    • Review clinical documentation across the network to identify patterns and trends in clinical documentation. Work with network providers to improve clinical documentation to better support CMS Risk Adjustment guidelines.
    • Develop education materials and tools to help network providers improve clinical documentation and support Hierarchical Condition Category coding capture.
    • Participate network performance improvement initiatives.
    • Safeguards medical records and preserves the confidentiality of personal health information through the observance of physician network policies pertinent to the release of medical record information, record retention, and HIPAA privacy and security.
    • Perform other duties and special projects as assigned.

    Qualifications

    Minimum Qualifications:

    • Associate degree in healthcare or equivalent work experience
    • 2-3 years of experience in outpatient coding
    • Familiarity and understanding of CMS HCC Risk Adjustment coding and data validation requirements
    • Computer literacy of medical information system, records management software, encoders
    • Advanced knowledge of CPT and ICD-10 coding required
    • Knowledge of federal and state guidelines on all coding systems and sponsored programs
    • Certified Professional Coder (CPC) or Certified Risk Coder (CRC)

    Additional Required Qualifications:

    • Strong belief in the principles of Integrated Care.
    • Strong negotiation skills, including proficiency in Motivational Interviewing and other therapeutic techniques.
    • Superior community resource knowledge, including knowledge of systems supporting members with serious mental illness.
    • Ability to effectively work cross functionally with interdisciplinary teams both inside and outside of the practice organization.
    • Familiarity and ability to teach medical terminology and concepts used in practice management
    • Proficiency in written communication, including ability to perform medical transcription
    • Computer literacy in order to navigate through electronic medical record, internal/external computer systems, including Excel and Microsoft Word.
    • Understanding of the benefits of evaluation and ability to provide supporting agencies with data and resources requested.
    • Professional boundaries with members
    • Superior time management skills, and able to manage and prioritize several high priorities at once
    • Experience in scribing in a medical records or proper clinical note taking

    Equal Employment Opportunity

    We are an equal opportunity employer committed to fostering a culturally diverse organization. We strive for inclusiveness and a workplace where mutual respect is paramount. We encourage applications from a diverse pool of candidates, and all qualified applicants will receive consideration for employment without regard to race, color, ethnicity, religion, sex, age, national origin, disability, sexual orientation, gender identity and expression, or veteran status. We will provide reasonable accommodations to qualified individuals with disabilities, as need, to assist them in performing essential job functions.

    Recruitment Agencies: 

    Dignity Health Management Services Organization does not accept unsolicited agency resumes. Dignity Health Management Services Organization is not responsible for any fees related to unsolicited resumes.

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