Director Of Risk Adjustment and Coding

Overview

Required Skills and Experience: • Certified Professional Coder (AAPC CPC or AHIMA CCS-P) • 7 years progressive leadership in an outpatient healthcare environment • 5 years of experience in Medicare Advantage • Fluent in revenue cycle management and healthcare financial performance. • Expert in documentation and coding requirements for professional services. • Thorough understanding of the relationship between codes and revenue in the reimbursement process, specifically how revenue is generated from ICD-10CM, CPT,HCPCS codes, and MEAT (Monitored, Evaluated, Accessed, Treated). • Expert knowledge of current coding guidelines and federal and state reimbursement program requirements, CMS Conditions of participation, MACs, NCCI edits. • Must have experience leading teams What you need to know: The Director of Risk Adjustment and Coding develops and directs medical coding, clinical documentation integrity, quality, and revenue integrity programs for Heal. This is a national leadership role reporting directly to the Chief Medical Officer that supports providers with a primary focus on relationship-based care while managing both fee for service and value-based care payment systems. The Director will establish system wide coding standards, policies and procedures related to charge capture, and professional coding and billing practices. This role will lead a team that provides complete and accurate coding, documentation improvement, and quality performance coding for Heal. This role will also provide education designed to promote complete and accurate reimbursement generated from ICD10, CPTI, and CPTII coding.

Benefits

Company

Through the touch of an app or a click on the website, our client enables patients to easily book on-demand or scheduled doctor house calls, 8 a.m. to 8 p.m., seven days a week, 365 days a year!