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Job Summary

Provides training and process improvement efforts across the clinical practices for the development of consistent and comprehensive clinical practices supported by the the Health Plan. Identifies process improvement opportunities associated with the management of risk adjustment initiatives. Investigates current processes, assessing efficiency and accuracy and provides solutions for problems, process improvement, development of training programs, and documentation strategies that support ICD-10 complex terminology for clinical practice operations and management.

Job Duties

• Reviews the content of the medical record professional outpatient records to identify all diagnosis codes applicable to the documentation.
• Carefully reviews details of documents such as laboratory findings, radiology reports, various scanned reports, discharge summaries, history and physical, consultations, orders, progress notes and other ancillary services treatment records needed to ensure all pertinent diagnoses are recorded.
• Translates all diagnostic and procedural phrases utilized by healthcare providers into coded form correct procedure codes as required.
• Using the Encoder software program, determines the codes for all diagnoses Reviews and understands annual mapping of ICD-9 and ICD-10 crosswalk.
• Provides education material to the team to educate physicians as needed to clarify documentation within the patient’s record to facilitate complete and accurate coding.
• Assists in decision making relevant to physician coding education and HCC targeting purposes.
• Works one-on-one with physicians as needed to clarify documentation within the patient’s record as appropriate accurate and complete coding.
• Assumes a supporting co-educating role with regard to Risk Adjustment Education and other opportunities for internal education team and external identified opportunities.
• Presents with full understanding of reports, presentations, maps and graphs, reflecting the collaboration of external and internal parties, summary and translation of data into actionable information.
• Delivers presentations to clinicians and administrators.
• Shares condition-specific training modules as requested.
• Works with provider sites to define solutions to needs or problem areas, and determines scope of investigation required to obtain solution.
• Solutions may include installation of alternate methods and procedures, changes in methods and practices, or redesign of products or services.
• Interprets and recommends actionable plans using financial and analytical data prepared by risk adjustment analysts.
• Provides consultative support to clinical areas on a daily basis and recommends operational strategies to achieve optimal documentation and coding processes.
• Assists in proactive risk adjustment communication, support and education at all levels within the organization.

Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.

This posting reflects an opening for Quality Coding and Documentation Educator I and we are seeking candidates for that position. Geisinger reserves the right to consider applicants for higher levels of this role based on their skills, qualifications, and experience. We encourage all qualified individuals to apply.

Position Details

Minimum diploma and certification requirements:

Level I

Coding Diploma/Degree

Level II

Certified Professional Coder (AAPC)

Level III and IV

Certified Professional Coder (AAPC) and Certified Risk Adjustment Coder (AAPC)

Education

Graduate from Specialty Training Program- (Required), High School Diploma or Equivalent (GED)- (Required)

Experience

Minimum of 1 year-Related work experience (Required)

Certification(s) and License(s)

Certified Risk Adjustment Coder - American Academy of Professional Coders (AAPC); Certified Professional Coder - American Academy of Professional Coders (AAPC); Registered Health Information Technician (RHIT) - American Health Information Management Association

Skills

Computer Literacy; Interpersonal Communication; Critical Thinking; Organizing

About Geisinger

Founded more than 100 years ago by Abigail Geisinger, the system now includes ten hospital campuses, a 550,000-member health plan, two research centers and the Geisinger Commonwealth School of Medicine. With nearly 24,000 employees and more than 1,700 employed physicians, Geisinger boosts its hometown economies in Pennsylvania by billions of dollars annually. Learn more at geisinger.org or connect with us on Facebook, Instagram, LinkedIn and Twitter.

Equal Opportunity Employer

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, pregnancy, genetic information, disability, status as a protected veteran, or any other protected category under applicable federal, state, and local laws.

Our Vision & Values

Everything we do is about making better health easier for our patients, our members, our students, our Geisinger family and our communities.

KINDNESS: We strive to treat everyone as we would hope to be treated ourselves.

EXCELLENCE: We treasure colleagues who humbly strive for excellence.

LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow.

INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation.

SAFETY: We provide a safe environment for our patients and members and the Geisinger family.

Our Benefits

We offer healthcare benefits for full time and part time positions from day one, including vision, dental and prescription coverage.