Job Information
McFarland Clinic PC Diagnosis Coding & Documentation Specialist (FT) |Pop Health|Ames| 2024-200 in Ames, Iowa
Description
McFarland Clinic is currently accepting applications for a Diagnosis Coding & Documentation Specialist for its Ames office. Candidates should be service-oriented, a team player, and be able to provide extraordinary care, every day to our patients.
GENERAL SUMMARY OF DUTIES: Responsible for determining the appropriate ICD10-CM diagnosis codes based on clinical documentation that follows the Official Guidelines for Coding and Reporting and Risk Adjustment guidelines for Hierarchical Condition Categories (HCC). The HCC Coder reviews retrospective medical record documentation and ensures that the codes are appropriately assigned. The outcome will be documentation that accurately and completely captures the clinical picture/severity of illness/complexity of the patient while providing specific and complete information to be utilized in coding, profiling and outcomes reporting of both the facility and the physicians. The HCC Coder utilizes standards of compliance, specifically in compliant query processes and clinical knowledge to identify opportunities and to achieve results.
SUPERVISION RECEIVED: Reports directly to Director of Population Health
HIPAA PROTECTED HEALTH INFORMATION (PHI) ACCESS CATEGORY: All—Unlimited access. Performances of such tasks are a condition of employment.
TYPICAL PHYSICAL DEMANDS: Requires prolonged sitting, some bending, stooping and stretching. Requires eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, etc. Occasionally lifts and carries items weighing up to 30 pounds. Requires normal range of hearing and eyesight to record, prepare, and communicate appropriate reports.
TYPICAL WORKING CONDITIONS: Work is performed in an office environment. Eligible for remote work.
EXAMPLES OF DUTIES: ( This list may not include all the duties assigned.)
Reviews medical record documentation and ensures that the codes are appropriately assigned.
Develops and maintains a productive and collaborative coding optimization and chart audit process for diagnosis coding (ICD-10 / HCC) to include a prospective review.
Must possess valid driver’s license, insurance and own transportation for use in work, and be flexible with working some evenings and weekends, within a 40-hour workweek
Ensures documentation supports ICD-10 / HCC codes assigned according to standards and identifies opportunities to optimize diagnosis coding based on documentation to maximize risk adjustment in ACO agreements.
Works with providers and staff to improve documentation and/or optimize diagnosis coding when opportunities are identified.
Educates providers and staff on commonly missed opportunities.
Collaborates with Supervisor and coding team to systematically prioritize patient charts for review and track audit results.
Reviews documentation available in the Medical Record to facilitate workflows that support the clinical picture/severity of illness/complexity of the patient care rendered to patients.
Reviews medical records to ensure accurate codes are applied to the encounter.
Actively participates in and maintains coding quality and productivity processes.
Collaborates with providers and coding staff on retrospective medical record review for severity, accuracy, and quality issues.
Ensures documentation in the medical record follows the official coding guidelines.
Creates and analyzes reports for coding improvement trending and high-level dashboards for ongoing monitoring and opportunities.
Provides ongoing feedback to physicians and other providers regarding coding guidelines and requirements.
Assists with educational in-services for physicians, other providers, and clinic staff relating to coding and documentation compliance as well as new policies and procedures related to billing.
Participates in training new coding staff, as needed.
Participates in auditing/reconciliation efforts for continuous quality improvement efforts.
Provides regular reports to the Supervisor.
Attends all required meetings.
Stays current with diagnosis coding regulations and guidelines and educates providers on changes as necessary.
Performs other tasks as assigned.
PERFORMANCE REQUIREMENTS:
Review documentation available in the Medical Record to facilitate workflows that support the clinical picture/severity of illness/complexity of the patient care rendered to patients.
Reviews medical records to ensure accurate codes are applied to the encounter.
Actively participate in and maintain coding quality and productivity processes.
Collaborates with providers and coding staff on retrospective medical record review for severity, accuracy, and quality issues.
Ensure documentation in the medical record follows the official coding guidelines.
Creates and analyzes reports for coding improvement trending and high-level dashboards for ongoing monitoring and opportunities.
Provide ongoing feedback to physicians and other providers regarding coding guidelines and requirements.
Assist with educational in-services for physicians, other providers, and clinic staff relating to coding and documentation compliance as well as new policies and procedures related to billing.
Participate in training new coding staff, as needed.
Participate in auditing/reconciliation efforts for continuous quality improvement efforts.
Willing to work as a team – innovation and collaboration is a priority.
Experience with a Epic
Knowledge of AHA coding guidelines and methodologies: HCCs, ICD-10-CM coding guidelines, Office of Inspector General (OIG) and Federal and State regulations
Extensive knowledge of medical terminology, anatomy, and pathophysiology, pharmacology, and ancillary test results.
Strong organization and analytical thinking skills – detail oriented
Proficient with Microsoft Office applications (Outlook, Word, Excel)
Demonstrates critical thinking skills, able to assess, evaluate, and teach
Self-motivated and able to work independently without close supervision
Strong communication skills (interpersonal, verbal and written)
Medical Record audits and review
Our employees play an essential role in our ability to enhance the health and well-being of our communities. As described in McFarland Clinic’s Employee-Level, Vision Related Behaviors, staff is responsible for:
Earning trust as compassionate, professional and respected leaders.
Coordinating the efficient delivery of patient-centered, quality health care.
Accomplishing the highest levels of quality and satisfaction for our patients.
Recognizing the vital connection between the well being of our staff and our patients by ensuring an outstanding work environment and a shared accountability for our patients’ health.
Knowledge, Skills, & Abilities:
Ability to work independently.
Ability to be an effective team member with innovation and collaboration as a priority.
Ability to read, write, understand and speak fluent English.
Knowledge of AHA coding guidelines and methodologies: HCCs, ICD-10-CM coding guidelines, Office of Inspector General (OIG) and Federal and State regulations.
Extensive knowledge of medical terminology, anatomy, and pathophysiology, pharmacology, and ancillary test results.
Strong organization and analytical thinking skills
Demonstrates critical thinking skills, able to assess, evaluate, and teach
Ability to be detail oriented, self-motivated and able to work independently without close supervision
Strong communication skills (interpersonal, verbal and written)
Skill with proficient use of Microsoft Office applications (Outlook, Word, Excel)
Proficient use of standard office equipment including computers, fax machines, copiers, printers, telephones, etc.
Education
High School diploma or equivalent.
Graduation from an accredited program for Medical Assistants or higher equivalent.
CMA required. RN preferred.
Certification/License
AAPC Certified Risk Adjustment Coder (CRC) preferred or willingness to obtain CRC certification within 3 months of employment.
Certification or registration from an approved certifying organization for Medical Assistants (AAMA, RMA, NCMA, CCMA).
Days: Monday - Friday
Hours: 8:00 AM - 5:00 PM
Experience
Minimum One (1) year of progressive coding experience.
Preferred Two (2) years progressive coding experience in multiple specialties, HCC Risk adjustment.
Clinical or medical office related experience (preferred).
Experience in chart auditing (preferred).
Experience with Epic Electronic Health Record systems (preferred).
Benefits
McFarland Clinic offers a comprehensive benefits package, including health and dental insurance, 401(k), and PTO. Click here (https://www.mcfarlandclinic.com/media/cms/BENEFIT_SUMMARY_2022Hourly_5698BB42CD3C6.pdf) for details.
McFarland Clinic is central Iowa's largest physician-owned multi-specialty clinic. Join our team and join a group of caring professionals, dedicated to providing Extraordinary Care, Every Day! We value quality care and extraordinary service, trusting relationships and an exceptional workplace. Our organization has more than 75 years experience of caring for people. We welcome applicants who can help us enhance the health and well-being of our patients and communities we serve.
All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of race, creed, color, religion, age, gender, gender identity, sexual orientation, national origin, disability, or protected veteran status. McFarland Clinic takes affirmative action in support of its policy to and advance in employment individuals who are minorities, women, protected veterans, and individuals with disabilities.
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)
