Cone Health
The Risk Adjustment Coding Educator provides coding education and support to THN practices including physicians, mid-levels, and support staff regarding understanding and capturing HCCs for appropriate THN members.
The coding educators provide prospective and retrospective chart review, provider assessments, one on one education and group education.
Responsible for using various reports from KPN, payors and internal applications such as Innovaccer to manage to workload and meet effectiveness and accuracy targets.
Responsible for reviewing electronic charts or paper charts when needed, to analyze appropriate use of ICD-10 coding guidelines, RAF coding guidelines and THN specific coding guideline.
Must complete associated forms such as the MRR, prospective review forms, provider assessments and daily logs with the findings from the reviews.ResponsibilitiesAbstracts diagnosis codes per THN policy from notes to be used to educate provider and staff on the importance of coding appropriately for HCC.
These codes may also be submitted to CMS and must meet coding guidelines.Prepare targeted education for providers and staff with practice specific information.Acts as a coding resource for practices and responds in a timely manner to inquiries.
May be asked to work on special coding related projects as requested by supervisor or payor which may include audits.Establishes and maintains a positive and professional working relationship with physicians, clinical, administrative and other staff as well as THN internal staff.Works with leadership team to establish EMR access within all practices.Actively participates in THN POD meetings with other THN departments.Completes daily logs and other process forms as directed by supervisor.QualificationsEDUCATION:High School Diploma or equivalent, RequiredBachelors, PreferredEXPERIENCE:Preferred:2 years prior RAF coding experience.LICENSURE/CERTIFICATION/REGISTRY/LISTING:Required:CPC ?Certified Professional CoderValid Drivers LicensePreferred:CRC-Certified Risk Adjustment Coder