Boston Medical Center (BMC)

We’re providing accessible and exceptional care to make a healthier Boston.

Manager, Risk Adjustment Coding

RiskRiskFull TimeRemoteTeam 5,001-10,000Since 1996H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

85 days ago

Salary

$72.5K - $105K / year

Associate Degree4 yrs expEnglish

Job Description

• Manage the day-to-day operations of the Risk Adjustment Coding Team. • Responsible for the development, implementation and performance of workflows for auditing electronic medical records. • Determine appropriate ICD10-CM diagnoses codes based on clinical documentation. • Support management of oversight of Coders and continuously work to improve people, process, and technology. • Collaborate with Value Based Care Team to manage accurate and compliant coding practices. • Contribute to the strategic direction for Risk Coding and collaborate with internal and external partners. • Establish KPIs for Risk Coding functions; ensure the implementation of action plans where performance is not meeting expectations. • Provide guidance and oversight for Risk Coding methodology, performance, and workflows. • Conduct reviews for clinical indicators and query providers to capture the severity of illness of the patient. • Measure Providers’ performance on important aspects of care and service. • Support the RA Team in a positive manner with emphasis on providing excellent service to all patients, providers, internal and external customers.

Job Requirements

  • Associates degree required, Bachelor’s degree preferred
  • Coding Certification from American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) required.
  • Minimum of four (4) years progressive coding and/or coding leadership experience in Risk Adjustment Coding
  • Experience with an Electronic Medical Record (EMR), EPIC preferred
  • Knowledge of AHA coding guidelines and methodologies: HCC’s and other RA methodologies, 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)
  • Medical Record audits and review
  • Familiarity with the external reporting aspects of healthcare
  • Strong knowledge of health records, computerized billing and charging systems, Microsoft applications, data integrity, and processing techniques required.
  • Excellent organizational skills, including ability to multi-task, prioritize essential tasks, follow-through and meet timelines.
  • Ability to work with accuracy and attention to detail
  • Must be able to maintain strict confidentiality of all personal/health sensitive information and ensure compliance of HIPAA rules and regulations.

Benefits

  • medical, dental, vision, pharmacy
  • discretionary annual bonuses and merit increases
  • Flexible Spending Accounts
  • 403(b) savings matches
  • paid time off
  • career advancement opportunities
  • resources to support employee and family well-being

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