Document and Coding Project Coordinator

Summary

The Documentation & Coding Project Coordinator is responsible for managing and monitoring the activities of the Clinical Documentation and Coding Department, in which they audit provider documentation and educate on coding practices along with other related projects that support Healthfirst's quality objectives.Duties & Responsibilities Responsible for expanding and improving medical records acquisition for RADV risk adjustment programManages relationships and effectively communicate with internal and external partners regarding quality objectives and targets as they relate to CMS audits.Collaborates with key departments on Quality driven initiatives championing process improvementAnalyzes data to identify data-driven opportunities for improvement and determine root causes in areas that need improvement to be successful in our CMS audits.Ensures a working relationship on internal group projects for process improvements.Analyzes data to identify trends, issues, and opportunities for performance improvement as it relates to clinical qualityPrepares quality improvement related presentations that accurately summarize complex information, details and dataAssists other departments with clinical documentation and coding initiativesProvides reporting and summaries on CMS audits in areas, but not limited to, noticeable trends, medical records, and issues.Ensures accuracy and completeness of medical records and complying with HIPAA guidelines.Analyzes invoice data to reduce billing errors and ensure billable info is correct for the Clinical Documentation and Coding Department audits.Additional duties as necessary and as directedMinimum Qualifications HS Diploma or GED from an accredited institution2-3 years in medical record retrieval in a health plan/ provider setting or administrative experience in lieu of health care settingStrong writing, time management, critical/creative thinking, communication, and problem-solving skills.Strong working knowledge of Microsoft Office Suite and OutlookPreferred Qualifications Associates degree or higher from an accredited institutionPrior experience in Managed Care/Health Insurance, in a health-related field or environmentBackground in health care or managed care. This can include work experience and/or education.Experience with a health plan's quality improvement/management departmentProficiency in multiple EMR systems (Epic, eCW, Athena, Cerner, etc.).Understanding of CMS RADV requirements and medical record documentation best practicesCompliance & Regulatory Responsibilities Ensures all work is compliant with relevant regulatory guidelines.License/Certification N/AHiring Range* Greater New York City Area (NY, NJ, CT residents): $48,600 - $65,960All Other Locations (within approved locations): $42,200 - $62,400As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.#J-18808-Ljbffr

Job Description

The Documentation & Coding Project Coordinator is responsible for managing and monitoring the activities of the Clinical Documentation and Coding Department, in which they audit provider documentation and educate on coding practices along with other related projects that support Healthfirst's quality objectives.Duties & Responsibilities Responsible for expanding and improving medical records acquisition for RADV risk adjustment programManages relationships and effectively communicate with internal and external partners regarding quality objectives and targets as they relate to CMS audits.Collaborates with key departments on Quality driven initiatives championing process improvementAnalyzes data to identify data-driven opportunities for improvement and determine root causes in areas that need improvement to be successful in our CMS audits.Ensures a working relationship on internal group projects for process improvements.Analyzes data to identify trends, issues, and opportunities for performance improvement as it relates to clinical qualityPrepares quality improvement related presentations that accurately summarize complex information, details and dataAssists other departments with clinical documentation and coding initiativesProvides reporting and summaries on CMS audits in areas, but not limited to, noticeable trends, medical records, and issues.Ensures accuracy and completeness of medical records and complying with HIPAA guidelines.Analyzes invoice data to reduce billing errors and ensure billable info is correct for the Clinical Documentation and Coding Department audits.Additional duties as necessary and as directedMinimum Qualifications HS Diploma or GED from an accredited institution2-3 years in medical record retrieval in a health plan/ provider setting or administrative experience in lieu of health care settingStrong writing, time management, critical/creative thinking, communication, and problem-solving skills.Strong working knowledge of Microsoft Office Suite and OutlookPreferred Qualifications Associates degree or higher from an accredited institutionPrior experience in Managed Care/Health Insurance, in a health-related field or environmentBackground in health care or managed care. This can include work experience and/or education.Experience with a health plan's quality improvement/management departmentProficiency in multiple EMR systems (Epic, eCW, Athena, Cerner, etc.).Understanding of CMS RADV requirements and medical record documentation best practicesCompliance & Regulatory Responsibilities Ensures all work is compliant with relevant regulatory guidelines.License/Certification N/AHiring Range* Greater New York City Area (NY, NJ, CT residents): $48,600 - $65,960All Other Locations (within approved locations): $42,200 - $62,400As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.#J-18808-Ljbffr