Coder

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.

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 is remote.

Position Summary:

The Value Based Coder is an employee of Dignity Health Managed Services Organization (DHMSO), a physician support organization owned by Dignity Health.
As a member of the Quality Management/Risk team, the Value Based Coder works with providers and office staff across DHMSO and its clinical integrated networks throughout 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.

Responsibilities may include:
- 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 in 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.

Minimum Qualifications:

- Certified Professional Coder (CPC) or Certified Risk Coder (CRC).
- Advanced knowledge of CPT and ICD-10 coding required.
- Associate degree in healthcare or equivalent work experience.
- Familiarity and understanding of CMS HCC Risk Adjustment coding and data validation requirements.
- Computer literacy of medical information system, records management software, encoders.
- Must have excellent verbal communication skills.
- Proficiency in MS office (outlook, excel, word).

Preferred Qualifications:

- 2-3 years of experience in outpatient coding preferred.