Coding Auditor I - Farmers Branch, TX SWHR CIN

Southwestern Health Resources (SWHR CIN) seeks to hire a Coding Auditor I to work Full Time supporting the Risk Adjustment department.

Please note: Southwestern Health Resources Clinically Integrated Network (SWHR CIN) is an affiliated company of Texas Health and UT Southwestern. If hired for this position, you will become a SWHR CIN employee rather than a Texas Health or UT Southwestern employee.

The address is 8150 Brookriver Drive, Dallas, Texas 75247

After SWHR Covid protocol ends, this position will office at the SWHR Corporate Headquarters, 1603 LBJ Freeway, Farmers Branch, Texas 75234

Salary range is Min. $25.11/hour to Max. $43.78/hour - based on relevant experience

Work Schedule

• Full Time; 40 Hours • Monday - Friday; 6:00 am - 6:00 pm; flex start/end time based on business needs • Must be available to work 8 hours per day

Job Description

Support comprehensive Risk Adjustment Coding and Documentation program to ensure documentation practices among providers comply with CMS Risk Adjustment requirements and ICD 10 Coding Guidelines.

HCC Chart Audits and Projects:

• Perform production goals set by team supervisor for HCC chart audits, form review, etc. while maintaining ≥ 95 accuracy • Ensure all chart audit results are shared to the provider per process in a timely manner • Assist in monitoring problems related to claims data in capturing HCC codes; providing assistance and training at the clinic level • Maintain tools, methods and standards for HCC coding and documentation • Daily crosschecking to meet quality standards • Meet projects with month end deadlines • Perform other job duties as assigned

Education:

• Provide education to providers on chart review results and any annual changes from CMS in regard to Risk Adjustment • Responsible for all education requests for clinics assigned

The ideal candidate will possess the following qualifications:

Education

Associate Degree Required and

Completion of an Accredited Coding Program Required and

1 year minimum experience in Medical Record Reviews, Documentation and Coding; preferably in an Ambulatory Physician Setting Required and

Experience Interpreting all types of Medical Records, including Physician Documentation Required

Comprehensive knowledge of ICD-9 and ICD10 with HCC experience Preferred

Or

2 years Relevant Work Experience in lieu of Degree Required and

1 year minimum experience in Medical Record Reviews, Documentation and Coding; preferably in an Ambulatory Physician Setting Required and

Experience in Interpreting all types of Medical Records, including Physician Documentation Required

Comprehensive knowledge of ICD-9 and ICD10 with HCC experience Preferred

Licenses and Certifications

CPC - Certified Professional Coder Certification Upon Hire Required, or

CPC-A - Certified Professional Coder Apprentice Upon Hire Required

Skills

Work independently while functioning as a team player.

Medical terminology, anatomy and physiology.

Intermediate skills in Microsoft Outlook, Word and Excel.

Excellent written and oral communication skills.

Supervision
Individual Contributor

ADA Requirements
Working Indoors 67% or more

Physical Demands
Sedentary