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Risk Adjustment Coding Reviewer
Banner Health
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Details
Posted: 31- Oct-21
Location: Phoenix, Arizona
Type: Full Time
Salary: Open
Categories:
Quality/Risk Management
Internal Number: R48813
Primary City/State: Phoenix, Arizona
Department Name: Clinical Performance Improveme
Work Shift: Day
Job Category: Risk, Quality and Safety
You have a location in the healthcare market. If you’re seeking to take advantage of your capabilities to make a genuine distinction – and genuine modification in the healthcare market – you belong at Banner Health. Apply today.
The Risk Adjustment group aims to supply finest in class threat modification education to our company neighborhood. The Clinical Risk Adjustment Educator is an essential function in this success. You will work carefully with internal groups in addition to the service provider network.
Banner Health provides a range of advantages to assist you and your household. We supply health and monetary security alternatives so you can concentrate on being the very best at what you do and enjoying your life
Banner Health Network (BHN) is a liable care company that signs up with Arizona’s biggest healthcare supplier, Banner Health, and a comprehensive network of medical care and specialized doctors to supply the most detailed health care options for Maricopa County and parts of Pinal County. Through BHN, understood nationally as an ingenious leader in brand-new healthcare designs, insurance coverage strategies and doctors are coming together to work collaboratively to keep members in ideal health, while lowering expenses.
POSITION SUMMARY
This position, utilizing a mix of information and chart evaluations, determines patterns in company coding. Implements when essential, education to service providers and their personnel to remediate locations of low efficiency. This position helps with the shipment of education/training products, performs and collaborates training and advancement of companies and their workplace personnel. Offers technical training in coding, run the risk of modification, paperwork, and billing functions.
CORE FUNCTIONS
1. Carries out medical record examines to examine paperwork to guarantee that medical diagnosis coding satisfies uniqueness requirements to support scientific indications.
2. Question suppliers concerning missing out on, uncertain, or clashing health record paperwork by asking for and acquiring extra documents within the heath record.
3. Assembles information and advises options relating to patterns or patterns observed in supplier coding. Supplies official training to service providers and personnel relating to coding, billing and paperwork requirements connected to run the risk of modification activity.
4. Assists, with concurrent coding to fulfill department goals/deadlines. Keeps a 96% quality audit precision rate.
5. Carries out potential, concurrent, and retrospective chart examines based upon department needs/goals.
6. Assists with research study and analysis for questions concerning compliance, coding, and unsuitable documents.
7. Carries out the minimum variety of coding quality evaluations constant with recognized department objectives. Maintains strictest privacy based upon HIPAA personal privacy policy.
8. Maintains present understanding of coding standards and pertinent federal policies through making use of present ICD-10- CM book, CMS handbooks, by going to academic workshops/conferences, examining expert publications, developing individual networks, and/or taking part in expert societies. This might likewise consist of carrying out continuous research study to guarantee compliance with scientific documents and/or regulative standards and requirements.
MINIMUM QUALIFICATIONS
Must have an existing understanding of organization and/or health care as usually gotten through conclusion of a bachelor’s degree in health care administration or associated field or have comparable experience.
This position needs a credential such as Registered Health Information Administrator (RHIA), Registered Health Information Technologist (RHIT) or Certified Coding Specialist (CCS) in an active status with the American Health Information Management Association (AHIMA) or a Certified Professional Coder (CPC) with active status with the American Academy of Professional Coders (AAPC). A legitimate Driver’s license and capability to drive to designated practices. Should be well versed in regulative requirements for ICD-10- CM Coding Guidelines, medical record paperwork, along with Medical Staff Rules and Regulations where suitable.
Requires the understanding usually obtained over 4 or more years of work experience in threat change. Medical terms, anatomy and physiology, and illness pathology understanding is needed.
Must have the ability to operate as part of a group, utilizing efficient social and training abilities. Should have exceptional composed, spoken, and customer care abilities, and have the capability to perform academic requirements analysis and to teach successfully to a large range of understanding levels.
Must excel in using typical workplace and discussion software application and have an innovative understanding and experience with computer system health care applications and hardware.
PREFERRED QUALIFICATIONS
Previous training/teaching experience and customer support education experience chosen.
Creativity and understanding of adult finding out principals chosen.
Hold the Certified Risk Adjustment Coder (CRC) credential or comparable specialized credential.
Additional associated education and/or experience chosen.
About Banner Health
What might draw you to Banner Health? A terrific healthcare profession, obviously– and an excellent location to live, no matter what phase of life you’re in. With centers throughout the West, there is a healthcare profession for everybody, from huge city living in the Phoenix location to friendly villages in the mountains and plains. As one of the biggest not-for-profit health systems in the nation, Banner Health uses both the stability that features success and the possibility of checking out brand-new locations of the nation. If you’re seeming an essential factor to a positive company, you’ll experience a wide array of expert benefits:
… Our extensive system provides you an unequaled range of scientific settings– from big city injury center to little rural medical facility, ambulatory to house health.
- Our dedication to health care development suggests you constantly have the most recent innovations within your reaches to assist you supply the finest care possible.
- The size, success and development of our system offer you with the stability and choices to pursue your preferred profession course.
- Competitive payment and thorough advantages use you alternatives to match your distinct requirements.
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American Health Quality Association.
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