Quality Coding Specialist - Vista Community Clinic

Overview

Vista Community Clinic is a private, non-profit, multi-specialty outpatient clinic providing care in a comprehensive, high quality setting. Located in San Diego, Orange and Riverside counties, we work to advance community health and hope by providing access to premier health services. Join dedicated, motivated, enthusiastic team players who make a difference in the community. Our competitive compensation and benefits program includes health, dental, vision, company-paid life, flexible spending accounts and a 403(B) plan, for eligible employees. VCC is an equal opportunity employer.

Responsibilities

Accurately review, interpret, audit, code and analyze medical records for diagnosis accuracy, clear documentation, and Hierarchical Coding Condition (HCC) abstraction according to ICD-10 CM coding guidelines and risk adjustment model regulations. Coordinate and collaborate with operational and clinical leadership to assist in identification of clinical best practices. Implement process improvements related to coding to appropriately document and capture risk burden of patients. Responsible for daily coding and auditing and providing guidance for other staff in the coding process.

• Perform PACE coding and auditing, working with clinicians on documentation and work flows as needed
• Review and accurately code medical records and encounters for diagnoses and procedures related to Risk Adjustment and HCC coding guidelines
• Ensure coding is consistent with ICD-10-CM, CMS-HCC, and other relevant coding guidelines
• Validate and ensure the completeness, accuracy and integrity of coded data
• Identify and resolve coding discrepancies or discrepancies between clinical documentation and diagnosis coding
• Collaborate with healthcare providers, physicians and other team members to clarify documentation and resolve coding queries
• Participate in coding education and training programs to enhance coding skills and knowledge
• Prepare and submit reports related to coding activities, coding accuracy, and any coding-related issues or trends
• Assist in internal and external coding audits to ensure the quality and compliance of coding practices
• Review documentation of every Annual Health Assessment in the Medical Record and Medical Diagnosis Report (MDX) to ensure accurate codes and documentation are applied to the encounter for billing
• Utilize available encoder, software and other coding resources to determine the appropriate ICD-10-CM diagnosis codes mapped to HCCs

Qualifications

Minimum Qualifications

• High school graduate or equivalent
• AAPC Coding certification
• Minimum three years’ medical billing experience
• Minimum two years’ medical coding experience

Preferred Qualifications

• Two years’ experience in an FQHC environment
• Experience with NextGen
• Experience in coding compliance program implementation

Pay Range

• $27.00 - $32.00 per hour DOE