RISK ADJUSTMENT - CODER AUDITOR in San Diego, CA at Scripps Health Plan Services -4S Ranch

Date Posted: 7/25/2018

Job Snapshot

Job Description

At Scripps Health, you will experience the pride, support, respect that has been repeatedly recognized as one of the nation’s Top 100 Places to Work.
You’ll be surrounded by people committed to making a difference in the lives of their patients and their teammates. So if you’re open to change, go ahead and unlock your potential.
This is a great opportunity for those with an eye for detail and enjoy a variation in daily activities. Be a part of this dynamic team.
  • Provides risk adjustment coding and educational support to the physician, leaders, sites, and support staff, and other coder/auditors related to risk adjustment.
  • Participates is risk adjustment coding education in the form of audits, email alters, training materials and onsite presentations.
  • Conduct audits of medical record documentation for HCC abstraction, interprets medical records and chart entries on coding and RAF determinations.
  • Collaborates in problem resolution, proactive strategies, and identification of best practices.
  • Utilizes multiple reports related to risk adjustment to determine focus audit or educational outreach and initiatives directly affecting reimbursement.
  • Reviews and updates encounter documents on a continuous basis, ensuring completeness and accuracy.
  • Ensures billing edit reports are resolved in an efficient manner with identification of problem trends affecting HCC.
  • Communicates effectively both verbally and in written format on correspondences related to risk adjustment.

Job Requirements

Required Education/Experience/Specialized Skills:
  • Minimum of three (3) years' experience in coding, medical documentation auditing in a multi-specialty setting, ambulatory care setting.
  • Demonstrates proficiency in the use of ICD-9/ICD-10 and CPT coding guidelines; ability to abstract and interpret medical records, predictive analytics and reports; highly organized; ability to educate and train all levels of professional staff.
Required Certification/Registration:
Required Certified Coding Specialist (CCS) Certification from the American Health Information Management Association (AHIMA) and/or (CPC) Certification from the American Association of Certified Coders (AAPC), and AAPC Risk Adjustment certification (if AAPC Risk Adjustment not obtained will obtain within 1 year of role).

Preferred Education/Experience/Specialized Skills/Certification:
  • Bachelor's degree and/or college coursework in a related field.
  • ICD-10 Certification.
Scripps Health is repeatedly named on the Fortune Magazine’s 100 Best Companies to work for, the only San Diego-based company and Becker’s Healthcare Top Hospitals. Scripps Health offers a robust Total Rewards Program designed to compensate and motivate you throughout your career. Scripps Health Total Rewards Program includes a broad range of plans and programs including market competitive pay and performance incentives, health and wellness benefits, financial wellness benefits, work-life resources, learning and development opportunities, and rewards and recognition. Unlock your potential with Scripps Health today.
Scripps Health is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex (including pregnancy, sexual orientation, or gender identity/expression), age, marital status, status as a protected veteran, among other things, or status as a qualified individual with disability.