Risk Adjustment Coding and Documentation Specialist

Risk Adjustment Coding and Documentation Specialist Job Code: 28980

• This position is responsible for facilitating the improvement in the overall quality, completeness, and accuracy of practice-based clinical diagnosis coding and documentation. Responsibilities
• Verifies and ensures the accuracy, completeness, specificity, and appropriateness of risk adjustable diagnosis codes and clinical documentation based on services rendered
• Engages KCN clinicians and their staff by supporting and educating on pre-visit planning to include identifying severity of patient illness
• Improves the provider coding experience by ensuring KCN clinicians and their staff receive regular feedback regarding coded cases and opportunities for improved documentation
• Supports KCN practices by analyzing chart documentation related to clinical status of patient, current treatment plan, past medical history and identifies potential gaps in provider documentation
• Serves as a resource by independently educating KCN clinicians and their staff by identifying errors and issues related to diagnosis coding and documentation to bring about a positive network value program outcome
• Develops program improvement plans and training materials
• Suggests and educates appropriate solutions in accordance with nationally recognized coding guidelines
• Actively engages and collaborates with payer partners on coding recapture and resolution of diagnosis
• Utilizes software and population health application to collect, track, and communicate information related to diagnosis coding
• Collaborates with KCN Contracting, Analytics and Information System teams to discern appropriate interventions for identified performance opportunities through enhancements or optimization to data, reports and population health application
• Performs other related duties as assigned
• Familiar with standard concepts, practices, and procedures within the field
• Relies on experience and judgment to plan and accomplish goals
• Regular and predictable attendance is an essential job function
• Competent to meet age specific needs of the unit assigned Requirements and

• Graduate of a formal coding program or completion of a coding training course required
• Associate degree required
• Minimum 3 years' coding/medical record chart review experience in a healthcare setting required
• Previous Risk Adjustment Methodology and diagnosis coding experience required
• Coding certifications through AHIMA or AAPC; Outpatient Coding: Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) or Certified Coding Specialist-Physician, (CCS-P), or other related certification required
• Certification as Risk Adjustment Coder preferred
• Experience with Hierarchical Coding Category (HCC) Risk Adjustment Model preferred
• HCC diagnosis coding and clinical record(s) review process preferred
• Strong knowledge of CPT and ICD-10 coding and medical record documentation
• Proven history of project management and/or coordinating detailed projects or activities
• Strong written and verbal communication skills, including ability to establish and build strong relationships Working Conditions
• Must be able to lift and move up to 10lbs
• Must be able to maintain a sitting position
• Typical equipment used in an office job
• Repetitive movements
• Remote eligible About Kootenai Health: Kootenai Health is a highly esteemed healthcare organization serving patients throughout northern Idaho and the Inland Northwest. We have been recognized with many accolades and distinctions, including being a Gallup Great Workplace, No. 1 Best Place to Work in Large Healthcare Organizations, and Magnet™ Status for Nursing Excellence. We pride ourselves on our outstanding reputation as an employer and a healthcare provider. As your next employer, we are excited to offer you: Kootenai Health offers comprehensive medical plan options, including options for fully paid employer premiums for our full-time employees. For part-time employees, we offer the same plan options with affordable part-time premiums. In addition to medical insurance, we offer many voluntary benefits ranging from dental and vision to life and pet insurance. Kootenai Health also offers well-being resources and telemedicine service options to all employees, regardless of benefit eligibility. Benefits begin on the 1 st of the month following 30 days of employment. Kootenai Health’s tuition assistance program is available after 90 days. If you want to further your education, we'll help you pay for it Kootenai Health sponsors retirement plans for employees that enable you to save money on a pre-tax and Roth after tax basis for your retirement. Kootenai Health will match your contributions based on years of service ranging from 3-6 percent. Competitive salaries with night, weekend, and PRN shift differentials An award-winning and incentive-driven wellness program. Including a MyHealth corporate team, onsite financial seminars, and coaching Employees receive discounts at The Wellness Bar, PEAK Fitness, and more Robust and interactive employee referral program And much more Kootenai Health provides exceptional support for extraordinary careers. If you want to work on a high-quality, person-centered healthcare team, we can't wait to meet you! Apply today! Please contact the HR Front Desk at 208-625-4620 or email careers@kh.org with any questions. Kootenai Health complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, veteran status, or sex. Kootenai Health does not exclude people or treat them differently because of race, color, national origin, age, disability, veteran status, or sex.