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As Director, Clinical Coding & Quality Documentation, you will have the opportunity to manage programs related to HCC coding, quality documentation and HEDIS.

Position Overview: Develop and manage programs related to HCC coding, quality documentation, and HEDIS reviews; including workflow design, physician and staff education.

Essential Duties and Responsibilities:

• Manage HCC coding and quality documentation initiatives
• Interface with IT to provide guidance around automating CPT codes and other ways to capture work for reporting without disturbing workflow for the practice
• Develop and manage provider coding education program for risk adjustment coding, documentation and compliance
• Support Population Health team with related coding initiatives
• Develop and manage Group wide coding policies and procedures as it relates to HCC coding and, quality documentation
• Manage our 3rd party coding partners including auditing, trending, and feedback to providers.
• Develop and design process with payers to submit HCC coding updates for RAF programs.
• Manage, coach and train staff and physicians on new coding systems and implementations
• Conduct compliance training to HCC staff, new and existing.
• Monitor new physician documentation, perform in-service with providers, educate staff and providers of coding changes.
• Ensure compliance with all applicable federal, state and local regulations, as well as Group policies and procedures.
• Tracking coding trends by physician to identify educational opportunities
• Work with clinical leadership and IT to keep our embedded tools up to date with latest HEDIS requirements
• Provide education and outreach to providers (in conjunction with clinical leadership) around changes in documentation requirements
• Help maintain dashboards and collaborate to strategize outreach on HEDIS outliers.
• Work with Clinical Leadership to prioritize HEDIS programs based on ease of achievement, clinical relevance, and ROI

Qualifications and Education:

• Bachelors Degree, or educational equivalent
• Risk Adjustment certification from AAPC
• Managerial experience and good organizational skills
• Experience with electronic health record systems and coding software
• Knowledge of laws and regulations pertaining to health information required.
• Advanced knowledge of HEDIS and Quality Documentation
• Strong knowledge of chart auditing/abstracting process
• Excellent written and verbal communication skills along with a working knowledge of word processing and PowerPoint systems.

Compensation: Commensurate with experience. All your information will be kept confidential according to EEO guidelines. Excellent benefits and other incentives provided.