The Value Based Coder II is an experienced professional within the Quality Management/Risk team, responsible for independently reviewing patient medical records to identify, assess, monitor, and review coding opportunities, with a growing emphasis on Hierarchical Condition Categories (HCC). This role focuses on developing and delivering provider education and contributing to process improvement initiatives. The Value Based Coder II acts as a valuable resource in identifying clinically appropriate risk-adjusting conditions and supporting provider documentation improvement.
- Independently review patient medical record information via population health tools on both a retroactive and prospective basis to identify, assess, monitor, and review network coding opportunities related to risk adjustment and HCC. Validate accuracy and completeness of HCC documentation and coding.
- Analyze clinical documentation across the network to identify patterns, trends, and opportunities for improvement related to HCC capture.
- Develop and deliver effective educational materials and provide targeted 1:1 provider education on documentation best practices, HCC guidelines, and risk adjustment principles.
- Monitor and interpret evolving HCC coding guidelines, CMS regulations, and compliance trends within risk adjustment, applying this knowledge daily.
- Champion compliance by advocating best practices and providing robust provider support to ensure adherence to federal and coding guidelines related to HCC and risk adjustment.
- Safeguard medical records and preserve the confidentiality of personal health information, complying with HIPAA and other policies.
- Participate in network performance improvement initiatives, offering insights based on coding expertise.
- Collaborate with providers and office staff to address documentation deficiencies and coding gaps.
Preferred Experience:
- 4+ years outpatient coding experience
- 3+ years focused on risk adjustment and HCC principles
Where You'll Work: Baylor St. Luke's Medical Center is an 881-bed quaternary care academic medical center in the Texas Medical Center, home of the Texas Heart Institute and a Magnet® hospital for Nursing Excellence. It offers adult and pediatric care for the Greater Houston area through main hospital and community emergency centers.
Pay Rate: $25.30 - $35.74 per hour
- Minimum 2 years experience in outpatient coding
- Minimum 2 years focused on risk adjustment and HCC principles
- Advanced knowledge of CPT and ICD-10 coding, with expertise in HCC coding guidelines and risk adjustment models
- Strong understanding of federal and state coding guidelines and sponsored programs
- Proficiency in developing and delivering educational content
- Effective verbal and written communication, interpersonal and presentation skills
- Ability to manage multiple priorities and work independently
- Computer literate with medical information systems, records management software, and encoder software
Preferred:
- 4+ years outpatient coding experience
- 3+ years focus on risk adjustment and HCC principles
Location
Houston, Texas, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
3 weeks ago