QCDI Coding Specialist

Job Summary

Your primary focus will be to facilitate and ensure the comprehensive capture of billing data for the purpose of accurately reporting HCC's, participate in the reconciliation of patient medical and billing records, and identify reimbursement/quality of care opportunities. Additionally, this role will provide provider education and review trends of assigned provider or medical groups.

Responsibilities

• Facilitate and ensure the comprehensive capture of billing data for accurate reporting of HCC's
• Participate in the reconciliation of patient medical and billing records
• Identify reimbursement/quality of care opportunities
• Provide provider education and review trends of assigned provider or medical groups
• Perform comprehensive chart reviews to ensure documentation required to facilitate the reporting of HCC diagnoses to payer
• Identify claims correction opportunities and submit to appropriate personnel for processing

Required Job Requirements

• 5 years experience as a clinic coder
• Extensive knowledge of payer contract guidelines
• Certified Professional Coder (CPC) or Certified Coding Specialist (CCS)
• Analytical and problem solving skills with the ability to understand clinical compliance guidelines, complex reimbursement structures and to apply contractual and governmental regulations to internal processes
• Superior organizational skills
• Superior written and verbal communication skills
• Able to work with minimum daily supervision

Preferred

• Bachelor’s degree or equivalent work experience

Where You'll Work

Dignity Health Medical Foundation, established in 1993, is a California nonprofit public benefit corporation with care centers throughout California. Dignity Health Medical Foundation is an affiliate of Dignity Health - one of the largest health systems in the nation - with hospitals and care centers in California, Arizona and Nevada. Today, Dignity Health Medical Foundation works hand-in-hand with physicians and providers throughout California to provide comprehensive health care services to the many communities we serve. As Dignity Health Medical Foundation continues to grow and establish new premier care centers, we provide increasing support and investment in the latest technologies, finest physicians and state-of-the-art medical facilities. We strive to create purposeful work settings where staff can provide great care, while advancing in knowledge and experience through challenging work assignments and stimulating relationships. Our staff is well-trained and highly skilled, qualities that are vital to maintaining excellence in care and service.