HCC Risk Adjuster and Coder

Brief Description

Miami Jewish Health is one of the largest providers of healthcare and living options for aging adults in the Southeast. Our main campus is located on 20\+ acres just north of mid-town Miami, and is home to our support departments like Finance, Accounting, Human Resources, Marketing and more. Join us now to do purposeful work with our diverse and respectful team.

Job Title:

HCC Risk Adjuster and Coder

Job Summary

Reviews medical records and accurately codes and sequences diagnosis in order to obtain maximum reimbursement.

Essential Job Functions

• Audits PACE medical record to ensure accuracy, upon enrollment and disenrollment, and assigns appropriate HCC codes per established department guidelines
• Performs follow up coding of medical records as a result of internal and external reviews which identify coding discrepancies
• Meet with PACE providers via MS Teams to assist with documentation improvement tied to reimbursement
• Assists with other department duties as necessary
• Attends department meetings and in-services as needed

Education

Job Requirements

• Associate degree in Health Information Management, or specialized training

Experience

• A minimum of 1 year of coding experience in Risk Adjustment models and Hierarchical Condition Category (HCC) and ICD-10-CM coding guidelines and coding system

Licenses/Certifications

• N/A

Abilities Required

• Knowledge of medical terminology, anatomy, and physiology
• Excellent communication, organizational and interpersonal skills
• Proficiency in using electronic health records (EHR) systems and coding software
• Knowledge of all MS Office applications
• Required to meet time sensitive deadlines
• Ability to multi-task
• Attention to detail and accuracy

Functional Demands

Environment Work Conditions

• Normal working condition with adequate lighting and ventilation

Infectious Material Exposure

• N/A

Organizational Expectations

• Ensures that resident’s/patient’s rights are adhered to
• Demonstrates professionalism and accountability
• Demonstrates a caring attitude consistent with Miami Jewish EmpathicareSM toward MJH residents, patients, family members, employees, and other facility guests
• Demonstrates excellent communication skills
• Ensures confidentiality and security of patients’ medical information
• Identifies and utilizes appropriate channels of communication
• Able to speak, read and write English
• Able to think and act calmly to meet unusual occurrences of the job
• Adheres to the organization’s Mission, Vision and Values
• Participates in departmental activities, meetings and in-services and follows established guidelines
• Maintains a safe working environment

Disclaimer

The above statements are intended to describe the general nature and level of work being performed by people assigned to this job. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities from time to time, as needed.

We believe in the power of empathy, the value of relationships and the importance of a life well-lived. Come see why Miami Jewish Health is unlike anywhere you’ve ever worked before. We offer competitive compensation, medical/dental/vision coverage and a 403(b)-retirement savings plan for eligible full and part-time positions, free on-campus parking, an onsite fitness center and more.

Miami Jewish Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.