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Senior Coding and Risk Adjustment Analyst

Company: Lee Health
Location: Fort Myers
Posted on: October 16, 2020

Job Description:

Risk Adjustment & Quality Manager is responsible for developing, implementing and maintaining physician, mid-level and CPC coder patient medical record coding for disease burden accuracy, quality, and overall provider education strategies around coding initiatives. The Manager will work to create reports and education materials to drive complete consistent coding, across the Innovatus Health Network, while managing a group of professional coders.

Additional job responsibilities may include but are not limited to:

* Serve as a Subject Matter Expert to internal and external stakeholders across Innovatus Health in Commercial as well as Direct to Employer payor arrangements

* In conjunction with leadership team develop a strategy for coding education through data and develop measureable action plans for provider(s) not meeting targeted coding accuracy goals

* Deliver on organization and client Quality goals in a highly matrixed work environment

* Steer centrally-administered education campaigns to result in efficient and effective outreach efforts

* Regular meet with administrative leads in the Innovatus Health Network to review current progress toward goals

* Maintain knowledge of current professional, regulatory, and industry trends to consult with internal and external stakeholders on standards and best practices.

* Support prospective partner presentations on the Quality value proposition in conjunction with business development efforts

* Experience with payers and billing including knowledge of ICD-10 coding guidelines

* Demonstrated track record for achieving performance results

* Ability to analyze and present data

* Excellent written and oral presentation skills, with the ability to engage, inspire, build credibility and engender trust across all levels of an organization

* Abides and demonstrates Standards for Ethical Coding as set forth in certifications.

* Attends workshops and brings back information appropriate to departments impacted by professional billing/coding. Keeps abreast of coding changes and technology.

* Demonstrate competency in use of technology and publications for coding research, HIPAA compliance and other issues impacting coding functions in professional billing/coding.

* Maintain certifications necessary to provide professional billing coding support to healthcare professionals to include maintaining or obtaining Healthcare Compliance certification if requested by the hiring department.

Additional Experience Requirements:

* Experience working with physicians directly

* Coding experience in HCC, RAF, ACO, CIN

Keywords: Lee Health, Fort Myers , Senior Coding and Risk Adjustment Analyst, Other , Fort Myers, Florida

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