Risk Adjustment Coding Specialist I
for section headings like About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. We must include sections only if posting has real specific content. We have content for About the role (company description and role summary). Responsibilities list. Qualifications list. Possibly Skills? The qualifications include many skill-like items; but we can treat them as Qualifications. There's also Compensation Range (Pay). So we need a Pay section with the range. No Benefits or Schedule mentioned. So we omit those.
We must not repeat job title as heading. The job title is Risk Adjustment Coding Specialist I. Not to be used as heading.
We need to preserve all substantive info. Remove boilerplate: EEO, accommodation contact, etc. Also remove "Equal Employment Opportunity" etc. Also remove "Physical Demands"? That's substantive? It's part of qualifications? Might be considered part of Requirements? It's about physical demands; could be included under Requirements or Qualifications. The instruction: preserve ALL substantive information; do not invent or summarize away detail. So we should keep physical demands info. Where to place? Could be under Requirements or Qualifications. Probably under Requirements (since it's about job demands). We'll include a subsection maybe as part of Responsibilities? Better to put under Requirements as a list.
We also have "Hybrid position and must be located in IN". That's location requirement. Should be included maybe under Requirements or a short p. We'll include a short p after the heading maybe.
We must not include application instructions, cookie/navigation/legal/EEO etc. So remove the EEO paragraph and accommodation contact.
We must not include duplicated lines.
Now craft HTML:
About the role
Formed in 2008 and headquartered in Fort Myers, Florida, with offices in Florida, North Carolina, and Texas, Millennium Healthcare is the largest independent physician group in the state of Florida and one of the largest in the United States. At Millennium Physician Group, our employees are the foundation of our success. Our promise is to provide you with the tools to do your job successfully, as well as providing a team atmosphere that empowers you to seek better ways to deliver care to our patients and their families. We also promise to care for you as an individual and help you grow in your role. The Risk Adjustment Coding Specialist I is responsible for reviewing the patient's medical record for clinical indicators supportive of an underlying diagnosis to be presented to a clinician for review during a subsequent face-to-face encounter. This role will leverage existing EHR tools and other technologies to identify suspect diagnoses impacting the patient’s health status. You will be required to prioritize and identify clinical indicators that are suggestive of an underlying condition. The Specialist is responsible for various aspects of decision- making and coding reviews to facilitate, obtain, validate, and reconcile appropriate provider documentation for clinical conditions that accurately reflect patient care needs. This role focuses primarily on Prospective medical record reviews.
Then maybe a short p for hybrid location:This is a Hybrid position and must be located in Indiana (IN).
Then Responsibilities heading with ul. List responsibilities from bullet points. We need to extract each responsibility line: - Verify patient insurance coverage, eligibility, and benefits, before service - Obtain prior authorization for all procedures, treatments, medications, and services, as required. - Perform prospective medical record reviews for clinical indicators supportive of an underlying diagnosis to be presented to a clinician for review during a subsequent face-to-face encounter. - Collaborate with healthcare providers and other stakeholders to clarify documentation and ensure accurate coding and reporting of diagnoses. - Stay updated on changes to Medicare guidelines, coding regulations, and reimbursement methodologies to ensure compliance and accuracy in coding practices. - Participate in coding education and training initiatives for staff to promote consistent and accurate coding practices across the organization. - Stays current on applicable coding and documentation guideline changes and rules. - Demonstrates knowledge of health systems operations, including an understanding of reimbursement methodologies and coding conventions. - Maintain strict adherence to patient confidentiality according to provider standards and government regulations. - Monitor and track the progress of referrals to ensure that patients receive the appropriate care promptly, providing regular updates to both patients and referring providers. - Demonstrates ability to perform accurate and complete patient medical record reviews for Hierarchical Condition Categories (HCC)/Risk Adjustment conditions. - Possesses advanced knowledge and understanding of HCC/Risk Adjustment, coding, and documentation requirements. - Establish and maintain effective working relationships with physicians, staff, and management. - Review patient medical records for clinical indicators. - Coordinate referrals to other healthcare providers as necessary. - Compile periodic reporting for various stakeholders. - Demonstrate excellent guest service to internal team members and patients. - Perform other related duties as assigned. Note some duplicates: "Review patient medical records for clinical indicators." appears also earlier; but we keep as is. Now Qualifications heading with ul. List qualifications: - High school Diploma or GED equivalent - 1+ years of experience, in a payer or healthcare-related field. - Must be proficient in 10-key, Word, and Excel. - Certified Procedural Coder (CPC), CRC designation preferred. - Certified Documentation Expert Outpatient (CDEO), OR AAPC or AHIMA Approved coding credential, or equivalent. - Maintains active professional certification and adheres to all industry educational, professional, regulations, and ethical requirements. - Organizational skills with a focus on tracking patient care and improving patient flow. - Proven knowledge of compliance and up-to-date guidelines regarding applicable coding and documentation. - Understands and complies with policies and procedures for confidentiality of all patient records, HIPAA, and security of systems. - Possesses excellent attention to detail. - Ability to maintain a consistent accuracy rate of 95% or above. - Works effectively and efficiently within a team environment. - Must be able to meet productivity standards established by Leadership. - Ability to work independently in a fast-paced, cross-functional environment. Physical Demands could be separate heading? Not in allowed headings list; but we could include under Requirements or Qualifications. Since we have Requirements heading maybe we should use Requirements for things like location, physical demands, etc. But we already used Qualifications for qualifications. The instruction: Use headings for section headings (e.g. About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule). So we can have both Requirements and Qualifications. We have not used Requirements yet. So we can put location and physical demands under Requirements. Qualifications for education/experience/certifications etc. Skills maybe not needed. Thus:Requirements
- This is a Hybrid position and must be located in Indiana (IN).
- Sedentary work. Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects.
- Repetitive motion. Substantial movements (motions) of the wrists, hands, and/or fingers.
- The worker must have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading.
- Ability to lift to 15 lbs. independently not to exceed 50 lbs. without help.
About the role
Formed in 2008 and headquartered in Fort Myers, Florida, with offices in Florida, North Carolina, and Texas, Millennium Healthcare is the largest independent physician group in the state of Florida and one of the largest in the United States. At Millennium Physician Group, our employees are the foundation of our success. Our promise is to provide you with the tools to do your job successfully, as well as providing a team atmosphere that empowers you to seek better ways to deliver care to our patients and their families. We also promise to care for you as an individual and help you grow in your role. The Risk Adjustment Coding Specialist I is responsible for reviewing the patient's medical record for clinical indicators supportive of an underlying diagnosis to be presented to a clinician for review during a subsequent face-to-face encounter. This role will leverage existing EHR tools and other technologies to identify suspect diagnoses impacting the patient’s health status. You will be required to prioritize and identify clinical indicators that are suggestive of an underlying condition. The Specialist is responsible for various aspects of decision- making and coding reviews to facilitate, obtain, validate, and reconcile appropriate provider documentation for clinical conditions that accurately reflect patient care needs. This role focuses primarily on Prospective medical record reviews.
Requirements
- This is a Hybrid position and must be located in Indiana (IN).
- Sedentary work. Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects.
- Repetitive motion. Substantial movements (motions) of the wrists, hands, and/or fingers.
- The worker must have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading.
- Ability to lift to 15 lbs. independently not to exceed 50 lbs. without help.
Responsibilities
- Verify patient insurance coverage, eligibility, and benefits, before service
- Obtain prior authorization for all procedures, treatments, medications, and services, as required.
- Perform prospective medical record reviews for clinical indicators supportive of an underlying diagnosis to be presented to a clinician for review during a subsequent face-to-face encounter.
- Collaborate with healthcare providers and other stakeholders to clarify documentation and ensure accurate coding and reporting of diagnoses.
- Stay updated on changes to Medicare guidelines, coding regulations, and reimbursement methodologies to ensure compliance