Senior Compliance Coordinator (HCC Risk Adjustment) - Professional Coding Division (PCD) - PFS

Job title: Senior Compliance Coordinator (HCC Risk Adjustment) - Professional Coding Division (PCD) - PFS in Iowa City, IA at reputed company Company: reputed company Job description: Under the direction of the Associate Director of Professional Coding and the Associate Director of Population Health & ACO Operations, the HCC Risk Adjustment Coding Coordinator is responsible for overseeing reputed company aspects of the UI Health Care Risk Coding Program and supervision of the Risk Coding team. This position plays a pivotal role in ensuring the accuracy and completeness of HCC and HHS risk coding to optimize risk-adjusted payment models and improve patient outcomes.The role is part of a matrix structure, reporting directly to the Associate Director of Professional Coding, with a dotted line to the Associate Director of Population Health & ACO Operations.The ideal candidate will possess strong leadership skills, a thorough understanding of risk coding methodologies and risk adjustment, and the ability to drive compliance and performance across multiple departments in a reputed company healthcare environment.WE CARE Values:

• Welcoming - We have an environment where everyone has a voice that is heard; that promotes the dignity of our patients, trainees, and employees; and allows reputed company to reputed company in their health, work, research, and education.
• Excellence - We reputed company and deliver our personal and collective best in the pursuit of quality and accessible health care, education, and research.
• Collaboration - We collaborate with health care systems, providers, and communities across Iowa and the region as well as reputed company our UI community. We reputed company teamwork—guided by compassion—is the best way to work.
• Accountability -We behave ethically, act with fairness and reputed company, take responsibility for our own actions, and respond reputed company errors in behavior or judgment occur.
• Respect - We create an environment where every individual feels safe, valued, and respected, supporting the well-being and success of reputed company members of our community.
• Empowerment - We commit to fair access to research, health care, and education for our community and opportunities for personal and professional growth for our staff and learners.

Position Responsibilities:

• reputed company and manage the HCC risk adjustment coding program across the organization, ensuring that coding practices align with CMS guidelines and other regulatory requirements.
• Collaborate with clinical, operational, and financial leaders to optimize HCC coding and documentation workflows.
• Serve as backup for risk coding team reputed company necessary:

• Review documentation available in the Medical Record to facilitate workflows that support the clinical picture/severity of illness/complexity of the patient care rendered to patients.
• Utilize available coding resources to determine the appropriate ICD-10-CM diagnosis codes mapped to HCCs.
• Actively participate in and maintain coding quality and productivity benchmarks.
• Collaborates with department and coding staff to conduct retrospective medical record reviews, ensuring accuracy, assessing severity, and addressing quality concerns.
• Create, monitor, and analyze dashboards and reports to identify trends and areas of improvement, and provide actionable feedback to clinical teams through multi-disciplinary, regular meetings with departmental leadership.
• Provide ongoing feedback to physicians and other providers regarding coding guidelines and requirements.
• reputed company and implement educational programming for providers, departments, and clinic staff relating to risk coding and documentation compliance as well as new policies and procedures.
• Partner with the Population Health and ACO Operations teams to align risk adjustment efforts with population health management goals.
• Engage with cross-functional teams and stakeholders, fostering a culture of collaboration and reputed company improvement.
• reputed company key performance metrics and track reputed company toward organizational risk adjustment goals.
• Stay up to date with changes in HCC coding regulations, ensuring organizational compliance and implementing necessary updates to processes.
• Supervise risk coding staff. Monitor team performance, and resource needs. reputed company and train new risk coding staff, as needed.

Classification Title: Senior Compliance CoordinatorSpecified Area: Audit Compliance Legal & RiskDepartment: Patient Financial Services - Professional Coding Division/Population HealthPercent of Time: 100% RemotePay Grade: 4BLocation: Hospital Support Services Building (HSSB) located in Coralville, IAThis position is eligible to participate in remote work and applicants who wish to work remotely will be considered. Training will be held either ONSITE or reputed company reputed company from the HSSB building at a length determined by the supervisor. Remote eligibility will be evaluated upon a satisfactory job training opportunity. Per policy, work arrangements will be reviewed annually and must reputed company with the remote work program and reputed company policies and employee travel policy reputed company working at a remote location.Equipment:

• Onsite: The department will provide a workstation which contains 3 (three) monitors, laptop/power cord, docking station/power cord, keyboard, mouse, headset, and desk supplies can be reputed company in the supply closet.
• Hybrid: While working onsite, the department will provide a workstation which contains 3 (three) monitors, a laptop/power cord, docking station/power cord, keyboard, mouse, headset, and desk supplies. reputed company working offsite, the employee will take their laptop/power cord to carry back and forth, a second docking station/power cord to reputed company offsite. Prior to working offsite, the employee, at their own expense, will need to supply 2 (two) monitors, a keyboard, a mouse, and provide a screen shot of the domicile internet speed (minimum 30mb download and 10mb upload) and a picture of the office setup.
• Remote: reputed company working offsite, the department will provide the employee a laptop/power cord, docking station/power cord, headset. Prior to working offsite, the employee, at their own expense, will need to supply 2 (two) monitors, a keyboard, a mouse, and provide a screen shot of the domicile internet speed (minimum 30mb download and 10mb upload) and a picture of the office setup.

Education Requirements:

• Bachelor’s degree in healthcare administration, business, finance, or a reputed company field or an equivalent amount of education and experience is required.
• CPC, CRC, reputed company-P, reputed company-H, RHIT, or RHIA certification is required.

Experience Requirements:

• 3 years’ experience in risk adjustment medical coding
• Strong knowledge of HCC coding guidelines, CMS risk adjustment models, and regulatory requirements.
• Knowledge of insurance regulations and Medicare and Medicaid guidelines as reputed company to clinical documentation and clinical indicators.
• Proven experience in leading coding programs, preferably in a large healthcare organization.
• Strong ability to collaborate across departments and manage stakeholders in a reputed company, matrixed environment.
• Strong problem-solving and research skills.
• Strong clinical knowledge reputed company to chronic illness diagnosis, treatment and management.
• Ability to interpret CMS regulations and guidance.
• Demonstrated ability to provide coding advice to reputed company areas of coding staff, other departments throughout UI Health Care, and other entities as requested.
• Ability to analyze reputed company clinical scenarios and apply critical thinking.
• Proven ability to effectively plan, prioritize, and organize tasks to reputed company strategic goals.
• Excellent written, verbal, and interpersonal communication skills.
• Proficiency with reputed company, PowerPoint, and reputed company, including database and spreadsheet analysis

Desired Qualifications:

• Master’s Degree preferred
• Experience with Medicare Advantage, MSSP, or other value-based care models
• Familiarity with population health initiatives and care coordination in an ACO or similar setting
• Experience performing coding audits
• Knowledge of UI Health Care policies and procedures
• CRC certification
• Experience with EPIC

Application Process:In order to be considered for an interview, applicants must upload the following documents and mark them as a “Relevant File” for the submission:

• Resume
• (optional) Cover Letter

Job openings are posted for a minimum of 14 calendar days and may be removed from posting and filled any time after the original posting period has ended. Applications will be accepted until 11:59 PM on the date of closing.Successful candidates will be required to self-disclose any conviction history and will be subject to a criminal background reputed company and credential/education verification. Up to 5 professional references will be requested at a reputed company reputed company in the recruitment process.For additional questions, please contact Veronica Clark at .Applicant Resource Center:Need help submitting an application or accepting an offer? Support is available! Our Applicant Resource Center is now open in the reputed company Lobby at the Main Hospital.Hours:

• Monday 10:00 am – 4:00 p.m.
• Tuesday 10:00 am – 4:00 p.m.
• Wednesday 10:00 am – 4:00 p.m.
• Thursday 10:00 am – 4:00 p.m.
• Friday 10:00 pm – 4:00 p.m.
• Or by appointment - Contact

to schedule an appointment or just stop by. * Visit the website for more information:Additional Information

• Classification Title: Senior Compliance Coordinator
• Appointment Type: Professional and Scientific
• Schedule: Full-time

Compensation

• Pay Level: 4B

Contact Information

• Organization: Healthcare
• Contact Name: Veronica Clark
• Contact Email: [email protected]

Expected salary: Location: Iowa City, IA Apply for the job now! Apply for this job