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Coding Consultant

Company: Confluence Health
Location: Wenatchee
Posted on: June 8, 2021

Job Description:

Position Summary:Network Strategy is responsible for producing and managing systems and information that assist healthcare providers in North Central Washington (NCW) ensure that the right care gets to the right patient at the right time; in other words: Value Added Care. The Health Alliance NW Coding Consultant consults with providers and clinical staff to ensure open communication and knowledge of risk adjustment initiatives, particularly relating to coding accuracy and quality improvement. They serve as the coding subject matter expert and act as the liaison for Health Alliance NW’s provider network. This role works collaboratively with other Coding Analysts and Leadership to strategically plan and execute Risk Adjustment coding efforts for accuracy and risk mitigation, as well as identify areas to implement process improvement. They conduct all presentations to provider groups, individual practitioners, and others for risk adjustment education. They also develop media outreach in collaboration with Confluence Health and Health Alliance. This position is a Confluence Health employee that is contractually leased to Health Alliance Medical Plans (HAMP). Essential Functions:Interacts with providers using exceptional verbal and written skills to facilitate risk adjustment education, training, and other related in-services for Health Alliance NW on a routine basis.Serves as the coding subject matter expert and coding consultant for Health Alliance NW. Conducts coding orientation, education, and monitoring for new and existing providers and other appropriate internal and external customers. Ensures adherence and maintains/submits necessary documentation associated with offering continuing medical education (CME) credits.Collaborates with team and leadership to strategically plan and execute coding efforts (targeting, key messaging, publications, website updates, provider reports, electronic medial record prompts, etc.)Works collaboratively and effectively with participating providers and health system/plan departments including, but not limited to: Claims, Medical Management, Customer Solutions, Compliance, Provider Relations, Enrollment, Risk Adjustment Revenue Management, and Contracting to ensure understanding of the importance of their respective functions and needs with our partnership and operations.Serves as a subject matter expert in the risk adjustment models and processes.Performs retrospective and prospective medical record reviews and auditing.Attends various revenue management/provider relations related meetings as requested. Exhibit commitment to continuous improvement through self-development and training opportunities.Other duties as assigned.Demonstrate Standards of Behavior and adhere to the Code of Conduct in all aspects of job performance at all times.Required:Bachelor’s Degree in business, healthcare management, or relevant field of studyMinimum of 2 years’ related experience Certified Professional Coder (CPC) or Certified Risk Adjustment Coder (CRC). Certification required within one (1) year of start date in position if not certified at hire. Certification must be maintained with required continuing education (CEUs).Possess software skills, particularly with Microsoft Office. Must project a professional, pleasant image while interacting with a variety of personalities at all levels, both in person and telephonically. Strong written and verbal communication skills and be adept at persuasion and problem solving. Ability to work independently, manage multiple tasks, be able to prioritize to achieve goals, and project confidence in all situations. Must have or obtain all necessary technical coding expertise as it relates to nomenclatures of Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), Diagnosis Related Groups (DRGs), and Internal Classification of Diseases. Must also be familiar with regulatory guidelines and their application to technical coding.Working Conditions:Work is performed in office, clinic, and hospital environments. Involves frequent contact with staff and the public. Involves occasional day travel and overnight/multiple day travel. Requires a combination of working independently and also working closely with others.Physical/Sensory Demands:O = Occasional, 1 to 25% or up to 30 minutes in a 2 hour workday.F = Frequent, 26 to 50% or up to 1 hour of a 2 hour workday.C = Continuous, 51% to 100% or up to 2 hours of a 2 hour workday.Physical/Sensory Demands forThis Position:Walking - F· Sitting/Standing - C· Reaching: Shoulder Height - F· Reaching: Above shoulder height - O· Reaching: Below shoulder height - O· Climbing - Not Specified· Pulling/Pushing: 25 pounds or less - O· Pulling/Pushing: 25 pounds to 50 pounds - O· Pulling/Pushing: Over 50 pounds - O· Lifting: 25 pounds or less - O· Lifting: 25 pounds to 50 pounds - O· Lifting: Over 50 pounds - O· Carrying: 25 pounds or less - O· Carrying: 25 pounds to 50 pounds - O· Carrying: Over 50 pounds - O· Crawling/Kneeling - O· Bending/Stooping/Crouching - O· Twisting/Turning - O· Repetitive Movement - FPhysical Exposures for This Position:Unprotected Heights - NHeat - YCold - YMechanical Hazards - NHazardous Substances - NBlood Borne Pathogens Exposure Potential - NLighting - YNoise - YIonizing/Non-Ionizing Radiation - NInfectious Diseases - NJob Classification:FLSA: Non Exempt Hourly/Salary: Hourly

Keywords: Confluence Health, Everett , Coding Consultant, Other , Wenatchee, Washington

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