This position assists with the delivery of education/training materials, conducts and coordinates training and development of Providers and their Office Staff provides technical training in the ICD-10-CM code set, Risk Adjustment, documentation, and billing functions. Using a combination of data and chart reviews identify patterns in provider coding. Implement when necessary education to providers and their staff to remediate on areas of low performance.
Conducts chart reviews for providers and review provider performance. This is accomplished by traveling to the individual practices and performing side-by-side education. Evaluates documentation to ensure that diagnosis coding is supported and meets specificity requirement to support clinical indicators. Query providers regarding missing, unclear or conflicting health record documentation by requesting and obtaining additional documentation within the heath record.
Develops relationships with clinical providers and communicate coding and documentation guidelines and requirements of the Risk Adjustment program to ensure correct coding, billing and documentation.
Analyzes data to prioritize provider educational reviews. Compiles data and present solutions regarding trends or patterns noticed in provider coding. Implements education, where necessary, and provides formal training to providers and staff regarding coding, billing and documentation standards.
Assists, as needed, with Concurrent coding to meet departmental goals/deadlines. Maintains a 96% quality audit accuracy rate.
Assists with research, analysis and response to inquiries regarding compliance, coding, and inappropriate coding.
Maintains current knowledge of coding guidelines and relevant federal regulations through the use of current ICD-10-CM book, CMS manuals, by attending educational workshops/conferences, reviewing professional publications, establishing personal networks, and/or participating in professional societies. This may also include performing ongoing research to ensure compliance with clinical documentation and/or regulatory guidelines and standards.
Must possess a current knowledge of business and/or healthcare as normally obtained through completion of a bachelors degree in healthcare administration or related field or possess equivalent experience.
This position requires a credential such as Registered Health Information Administrator (RHIA), Registered Health Information Technologist (RHIT) or Certified Coding Specialist (CCS) in an active status with the American Health Information Management Association (AHIMA) or a Certified Professional Coder (CPC) with active status with the American Academy of Professional Coders (AAPC). A valid Drivers license and ability to drive to assigned practices.
Must be well versed in regulatory requirements for ICD-10-CM Coding Guidelines, medical record documentation, as well as Medical Staff Rules and Regulations where applicable. Requires the knowledge typically acquired over four or more years of work experience in risk adjustment. Medical terminology, anatomy and physiology, and disease pathology knowledge is required. Must be able to function as part of a team, using effective interpersonal and instructional skills. Must possess excellent written, verbal, and customer service skills, and have the ability to conduct educational needs analysis and to teach effectively to a wide range of comprehension levels.
Must be proficient in the use of common office and presentation software and have an advanced knowledge and experience with computer healthcare applications and hardware.an advanced knowledge and experience with computer healthcare applications and hardware.
Previous training/teaching experience and customer service education experience preferred. Creativity and knowledge of adult learning principals preferred. Hold the Certified Risk Adjustment Coder (CRC) credential or similar specialty credential. Hold the Clinical Documentation Improvement Outpatient (CDIP) credential or similar CDI focused credential.
Additional related education and/or experience preferred.
Internal Number: 266204
About Banner Health
You want to change the health care industry – one life at a time. You belong here. You’re excited to be part of the dramatic changes happening in the health care field. In fact, you thrive on change. But you also understand that excellent, compassionate patient care is the true measure of the success of these changes. You belong at Banner Health. Our award-winning, comprehensive health system includes 23 hospitals in seven western states, primary care health centers, research centers, labs, a network of physician practices and much more. Throughout our system, skilled, compassionate professionals use the latest technology to change the way care is provided. If you’re looking to be a key contributor to a forward-looking organization, you’ll experience a wide variety of professional advantages: •Our vision for changing the future of health care gives you the opportunity to leverage your abilities to achieve something historic. •Our expansive system offers you an unmatched variety of clinical settings – from large urban trauma center to small rural hospital, ambulatory to home health. Our system also includes hospitals specializing in cancer, heart health and pediatrics. •Our many loc...ations also translate into a broad selection of exciting and rewarding lifestyle options – from the big city to the wide-open spaces. •Our commitment to healthcare innovation means you always have the latest technologies at your fingertips to help you provide the finest care possible. •The size, success and growth of our system provide you with the stability and options to pursue your desired career path. •Our competitive compensation and comprehensive benefits offer you options to complement your unique needs.