Employment Type:Full timeShift:

Description:Excellence in care takes the dedication and commitment of not only our front-line care teams, but of the specialized professionals that support all aspects of our mission. Colleagues in Finance, HR, Marketing and more keep Mount Carmel operating at the highest standard. And we provide leading education training and development opportunities to keep you working at yours.

Risk Adjustment Coding Specialist works in a team environment and is responsible for ensuring accurate ICD-9/10 documentation for the patient billing process.

Submits appropriate claim adjustments to Billing Department for submission of corrected claims.Reviews Payor data for Gaps in Care and RAF Scores

Responsibilities   

Completes and submits Medicare Patient Assessment Forms and maintains accurate database of submission and payment.Ensures medical documentation and coding compliance with Federal, State and Private payer regulations.Participates in seminars and continuing education activities pertinent to areas of job responsibilityReviews patient record prior to appointment to determine Gaps in Care, then communicates Gaps to provider.Educates and assists Coding Specialists to accurately code ICD-9/10 to highest level of specificity.Follows current industry standards of ethical coding. Recognizes opportunities for documentation improvement and educates providers and staff of suggested improvements.Works collaboratively with providers to completely reflect patient's clinical status and care; works with providers to develop documentation improvement plans.Collaborates with providers to formulate appropriate modifications to clinical documentation to reflect the appropriate use of clinical codes and documentation.

Qualifications

High School Diploma or equivalent required Completes and submits Medicare Patient Assessment Forms and maintains accurate database of submission and payment.Certified Risk Adjustment Coder certification within one year of hire required.Minimum of two years of experience in medical coding and billing requiredUnderstanding of various medical claims formats.Working knowledge in medical terminology, CPT and ICD-9/10 coding, and subsequent ICD versions.Expanded knowledge of Risk Adjustment and HCC coding.Knowledge of payer contracts and reimbursement.

Discovering opportunities, support and excellence – all while making a real difference in patients’ lives – begins at Mount Carmel. Find a new beginning and advance your career with us.

Mount Carmel and all its affiliates are proud to be equal opportunity employers. We do not discriminate on the basis of race, gender, religion, physical disability or any other classification protected under local, state or federal law.

Our Commitment to Diversity and Inclusion
 

Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.