Boston Medical Center (BMC)
We’re providing accessible and exceptional care to make a healthier Boston.
Manager, Risk Adjustment Coding
Location
United States
Posted
85 days ago
Salary
$72.5K - $105K / year
Associate Degree4 yrs expEnglish
Job Description
• Manage the day-to-day operations of the Risk Adjustment Coding Team.
• Responsible for the development, implementation and performance of workflows for auditing electronic medical records.
• Determine appropriate ICD10-CM diagnoses codes based on clinical documentation.
• Support management of oversight of Coders and continuously work to improve people, process, and technology.
• Collaborate with Value Based Care Team to manage accurate and compliant coding practices.
• Contribute to the strategic direction for Risk Coding and collaborate with internal and external partners.
• Establish KPIs for Risk Coding functions; ensure the implementation of action plans where performance is not meeting expectations.
• Provide guidance and oversight for Risk Coding methodology, performance, and workflows.
• Conduct reviews for clinical indicators and query providers to capture the severity of illness of the patient.
• Measure Providers’ performance on important aspects of care and service.
• Support the RA Team in a positive manner with emphasis on providing excellent service to all patients, providers, internal and external customers.
Job Requirements
- Associates degree required, Bachelor’s degree preferred
- Coding Certification from American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) required.
- Minimum of four (4) years progressive coding and/or coding leadership experience in Risk Adjustment Coding
- Experience with an Electronic Medical Record (EMR), EPIC preferred
- Knowledge of AHA coding guidelines and methodologies: HCC’s and other RA methodologies, ICD-10-CM coding guidelines, Office of Inspector General (OIG) and Federal and State regulations
- Extensive knowledge of medical terminology, anatomy, and pathophysiology, pharmacology, and ancillary test results
- Strong organization and analytical thinking skills – detail oriented
- Proficient with Microsoft Office applications (Outlook, Word, Excel)
- Medical Record audits and review
- Familiarity with the external reporting aspects of healthcare
- Strong knowledge of health records, computerized billing and charging systems, Microsoft applications, data integrity, and processing techniques required.
- Excellent organizational skills, including ability to multi-task, prioritize essential tasks, follow-through and meet timelines.
- Ability to work with accuracy and attention to detail
- Must be able to maintain strict confidentiality of all personal/health sensitive information and ensure compliance of HIPAA rules and regulations.
Benefits
- medical, dental, vision, pharmacy
- discretionary annual bonuses and merit increases
- Flexible Spending Accounts
- 403(b) savings matches
- paid time off
- career advancement opportunities
- resources to support employee and family well-being
Related Guides
Related Categories
Related Job Pages
More Risk Jobs
Risk Management
Big I IllinoisSustainable Competitive Advantage | Unrelenting Advocate for Independent Insurance Agents in Illinois | 12,000 Strong
Risk86 days ago
Full TimeRemoteTeam 11-50Since 1899H1B No Sponsor
Insurance Agent managing own book of business while working remotely
Risk Investigations Specialist – Trust & Safety
Control RisksThe global specialist risk consultancy - Helping organisations succeed in a volatile world
Risk86 days ago
Full TimeRemoteTeam 1,001-5,000Since 1975H1B Sponsor
Risk Investigations Specialist monitoring offline risks for major tech client
SQL
Senior Risk Analyst
AlkymiAlkymi is the leader in intelligent document processing and data workflow automation.
Risk86 days ago
Full TimeRemoteTeam 11-50H1B Sponsor
Senior Risk Analyst implementing lending solutions at Alkami
Risk87 days ago
Full TimeRemoteTeam 10,001+Since 1833H1B Sponsor
Director of Data Governance leading strategy and execution in dynamic healthcare organization
Texas