Job Title: Clinical Documentation Manager and Educator (HCC)
Location: Irving, Texas
Reports To:VP RCM
FLSA: Exempt
Job Description:
Candidates will have 5+ combined years of Clinical Documentation Integrity skills that will provide Clinical Documentation Integrity concepts and promote accuracy in physician documentation. Lead creating action plans for improvement in client's physician documentation and documentation practices. Actively participate in operations and client success discussions, leading improvement in risk adjustment accuracy.
Supervisory Responsibility: This position does not have supervisory responsibility.
Travel Requirements:
35%+ travel
Domestic travel by airplane and vehicle within the US typically requires 1-3 overnights/week as needed.
International travel required.
Valid Passport required.
Valid Driver's License required.
Residing within a 30-minute proximity to a major airport hub to facilitate efficient travel arrangements.
The value you'll bring to the team:
Provide clinical documentation integrity education and training to physician(s), physician groups and Advanced Practice Providers.
Support provider onboarding to OnPoint Coding Platform including orientation to prospective and retrospective coding workflows.
Complete chart reviews on Physician(s) and Physician Groups and provide education with feedback based on results of review.
Engage in and drive provider documentation best practices, including education on themes for opportunity and accuracy improvement.
Perform code abstraction audits of medical records to ensure complete capture of Hierarchical Condition Categories (HCCs) codes are accurately assigned and supported by clinical documentation in accordance with all state regulations, federal regulations, internal policies, and internal procedures.
Identify diagnosis and chart level impairments and documentation improvement opportunities for provider education.
Conduct provider education and training regarding risk adjustment to help ensure accurate CMS payment and improve care quality. This includes training venues such as provider offices, hospitals, webinars, conference calls, email correspondence, etc.
Identify practices that need initial and ongoing additional training.
Responsible for building positive relationships with assigned physicians and serving as a contact for any questions or concerns that may arise.
Maintain current knowledge of ICD-10-CM codes, CMS documentation requirements, and state and federal regulations.
Consistently audits the coding auditors to ensure they maintain a minimum 95% accuracy on coding quality audits.
Acts as the liaison between the OPHP offshore teams and the clients.
Maintain close alignment with the market leaders to ensure project target and clients expectations are met.
Perform monthly review of clients' invoices to ensure accuracy and identify potential opportunities by closely monitoring the dashboards.
Meet minimum productivity requirements as outlined by the project terms.
Ability to adhere to client guidelines when superseding other guidelines.
Assist Onpoint's Operations leadership by making recommendations for process improvements to further enhance coding goals and outcomes.
Handle other related duties as required or assigned.
Education and Qualifications:
2+ years direct coding experience within Medicare (Medicare advantage and Medicare ACO) preferred (HCC Coding)
Minimum of 1 year coding experience with Complete Code Capture
3+ years coding education, management and/or QA within Medicare Advantage and/or Medicare ACO) G
CPC, CRC, CDEO, or CDEI current certification
Risk adjustment compliance and RADv guidelines
Coding education for providers; 1:1, small group and large group
Project management experience preferred
Excellent organizational skills
Excellent verbal and written communication skills
Proficient with Microsoft Office Suite
Eligible to work in the U.S. without relying solely on a student visa or a visa sponsored by a third-party employer.
Core Competencies:
Flexible, Detail Oriented, Customer Focus, Team Working, Initiative, Problem Solving, Organized, Self-Motivated
General:
Adopt the OnPoint culture of respect, integrity, and accountability that contributes to an internal environment of teamwork and promotes a positive brand image to our external customers.
Incorporate a leadership mindset to your role.
Comply with OnPoint procedures, policies, and regulations relevant to your role.
Successfully completes all OnPoint training requirements (i.e. HIPAA, compliance, etc.)
Responsible for compliance with all regulatory requirements and/or guidelines. These requirements/guidelines include, but are not limited to: HIPAA, Federal Fraud and Abuse laws.
Able to communicate effectively with others, both verbally and in writing.
Proven ability to manage time, meet deadlines and prioritize.
Able to maintain standards and professionalism during periods of fluctuating workloads.
Provide professional service to direct customers and vendors/delivery partners of OnPoint in all interactions.
Build effective working relationships with other team members.
Manage daily tasks to ensure business needs are consistently met.
Excellent customer service skills.
Able to work independently and as part of a team.
Able to handle multiple tasks and prioritize work effectively.
Physical Demands:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
While performing the duties of this job, the employee is regularly required to speak, hear, read, and type. The employee must be able to travel by airplane and vehicle in order to meet with internal and external customers.
This is largely a sedentary role; however, some shipping may be required. This position requires the ability to occasionally lift office products and supplies up to 20 pounds.
Work Environment:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill and/or ability required.
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time, with or without notice.
Interested applicants should apply and submit their resume at: OnPoint Healthcare Partners - Application