Community Health Provider Alliance (CHPA)

Position:The value-based coding advisor (also referred to as a 'risk adjustment and coding advisor') supports coding accuracy, medical record documentation, quality gap closure, and provider education in the Community Health Centers (CHCs) participating in the Community Health Provider Alliance (CHPA) Accountable Care Organization (ACO).. The Value-Based Coding Advisor will interact with operational and clinical leadership to assist in the identification of Risk Adjustment/HCC coding opportunities and will provide targeted education to CHC providers, billers, coders, and support staff to support value-based contract initiatives.. Assist the department, direct supervisor, and CHPA in the development of education tools related to risk adjustment/HCC coding and gap closure.. Supports the creation of education that will train CHC providers, billers, coders, and support staff, as well as CHPA staff, for risk adjustment/HCC coding opportunities.. To achieve high-quality outcomes the Value-Based Coding Advisor is to have knowledge of HEDIS/STARs measures and guidelines, CMS Hierarchical Condition Category (HCC) coding guidelines, clinical documentation standards, and education/training skills.

risk adjustment

Status: Non-Exempt (hourly)Report To: Supervisor of Risk Adjustment & QualitySupervises: N/APosition Pay Range: $55,953 $83,930 Position:The value-based coding advisor (also referred to as a 'risk adjustment and coding advisor') supports coding accuracy, medical record documentation, quality gap closure, and provider education in the Community Health Centers (CHCs) participating in the Community Health Provider Alliance (CHPA) Accountable Care Organization (ACO). The personnel in this position will use their knowledge of risk adjustment coding, documentation guidelines, and report generation to assist in any coding and auditing-related functions determined by their direct supervisor or CHPA leadership. Responsibilities: The Value-Based Coding Advisor will interact with operational and clinical leadership to assist in the identification of Risk Adjustment/HCC coding opportunities and will provide targeted education to CHC providers, billers, coders, and support staff to support value-based contract initiatives. Risk Adjustment/HCC Coding Support and EducationEducates providers and staff on coding regulations and changes as they pertain to risk adjustment and quality reporting to ensure compliance with federal and state regulations.Assist the department, direct supervisor, and CHPA in the development of education tools related to risk adjustment/HCC coding and gap closure.Supports the creation of education that will train CHC providers, billers, coders, and support staff, as well as CHPA staff, for risk adjustment/HCC coding opportunities.Maintains a database with the results of all medical chart reviews performed, with the ability to report on progress and statistics on coding initiatives.Pre-Visit Planning (PVP)Performs weekly Pre-Visit Planning reviews for assigned CHCs, and will query providers or other identified team members to further value-based contract initiatives including coding recommendations based on internal and external medical records, review of payer portals and suspected conditions, and review of care gap and clinical documentation. CHC SupportHolds monthly meetings with identified coding champions, provide education and training to CHC providers, billers, coders, and support staff in proper coding guidelines; and documentation education based on PVP observations and monthly topics.Provides monthly chart reviews of randomly selected patients and providers participating in Pre-Visit Planning (PVP) program to give feedback on missed opportunities and errors. Gap Closure SuccessReviews patient charts to identify areas for quality gap closures and provide compliant documentation to appropriate payers resulting in gap closures for assigned CHCs.Ensures that providers understand CPT II coding for quality gap closure and reporting. CHPA SuccessAssist in all CHPA dashboard and scorecard initiatives to improve performance outcomes.Assist supervisor in implementing best practices, policies, and procedures to increase support services to the CHCs we serve.Assist in developing and sharing guidelines/best practices with internal risk adjustment coders to help improve coding documentation techniques for our members.Helps with special projects within the Risk Adjustment Department. Behavioral Expectations:Display a positive and respective attitudeProvide excellent customer service to our membersRepresenting the organization in a responsible and respectful mannerWorking with honesty and integrityPerforming job duties to a reasonable, acceptable standardMaintaining great communication with the team and our membersConducting themselves in a professional manner, especially when serving our members and communicating with peersFollowing set policies and procedures when dealing with problems or issues Team Expectations:Respect each other, and be courteous and sensitive to peoples needs and concernsBe accountable for your workBe flexible about job and task assignmentsBe willing to help each otherAsk for help when needed following CHPAs chain of commandBe open to constructive feedback without being defensive or negativeBe self-motivated and reliableShare ideas for improvement respectfullyBe positive and encouraging to other team members Qualifications: To achieve high-quality outcomes the Value-Based Coding Advisor is to have knowledge of HEDIS/STARs measures and guidelines, CMS Hierarchical Condition Category (HCC) coding guidelines, clinical documentation standards, and education/training skills.High School diploma or equivalentMinimum 2 years coding experienceThe American Academy of Professional Coders (AAPC) Certified Risk Adjustment Coder (CRC) certification is required; Certified Professional Coder (CPC) Certification will be considered with Risk Adjustment/HCC Coding experience and willingness to obtain CRC within 1 year of employmentRisk Adjustment experience requiredExperience with clinic billing and coding requiredKnowledge of several EHR systems preferred (ECW, Athena, Greenway Intergy, Epic).Clinical background preferredStrong knowledge of CMS coding and quality guidelines.Strong knowledge of PowerPoint, excel and Microsoft word with the ability to manipulate basic information and data required for preparing reports and delivering trainingExceptional interpersonal, public speaking, and presentation skills to deliver training and education is preferred.Ability to facilitate group discussions that challenge participants and promote discussion of new approaches and solutions based on data and value-based care initiatives.Ability to adapt to changing initiatives and priorities based on the needs of CHPA and the CHCs success.Ability to professionally communicate and manage conflict with others in both an internal and external settingAbility to work independently and to self-motivate to complete tasks; resourceful and proactiveFluency in written and spoken English, with reading comprehension skillsDisplays cultural competence in diversity, equality, equity, and inclusion to fit CHPAs cultural values and missionAbility to travel to and within the state of Colorado- 25% travel within the state of Colorado with an unrestricted drivers license and an insured vehicleProof of full COVID-19 vaccination may be required for employmentHome office that is HIPPA compliant and has high-speed internet capabilityMobile device for work purposes Working Environment and Physical Activities: Hybrid position- work from home with 25% travel capabilityThis position requires several hours of travel to meetings in the state of Colorado CHPA is an equal opportunity employer offering a generous benefits package, a casual work environment, and a competitive salary (DOE):Insured group health, dental, and vison plans (NOTE: Medical Insurance may not be available for out-of-state employees)Medical and dependent care flexible spending account options401k retirement plan with an employer contribution matchLife, AD&D, and Long-term disability plans paid for by employerFree 24/7 access to confidential resources through an Employee Assistance Program (EAP)Voluntary benefit plans to complement health care coverage including accident insurance, critical illness, and short-term disabilityA generous mix of vacation, sick and holiday paid days off View the full job description: https://chpanetwork.com/careersby Jobble
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