Medicare Risk Adjustment HCC Coding and Clinical Documentation Analyst - Oklahoma City or Wichita Humana 4,097 reviews - Oklahoma City, OK Medicare Risk Adjustment HCC Coding and Clinical Documentation Analyst - Oklahoma City or Wichita: 193809 Primary Location: US-Kansas-Wichita Other Locations: US-Oklahoma-Oklahoma City Work Environment Type: Virtual/Work At Home Schedule: Full-time Travel: Yes, 25 % of the Time Medicare Risk Adjustment HCC Coding and Clinical Documentation Analyst This role is responsible for conducting retrospective, prospective and concurrent reviews for the Medicare Risk Adjustment organization to identify documentation improvement opportunities according to CMS and ICD-10 risk adjustment coding guidelines. In this role you will be working collaboratively with providers, coder, and/or office staff performing coding and review onsite. This role reports to the Coding Frontline Leader. Work will require 50% travel in your local market. Key Role Responsibilities * Provide direction and give guidance on coding best practices * Responsible for identifying the impact of documentation and coding on risk adjustment model * Evaluate the element of the medical record for diagnosis code selection * Educate healthcare provider, coder and/or office staff about the risk adjustment model, documentation and coding * Improve the practices documentation and coding accuracy and help the practice adopt more efficient and effective processes * Create a long-term, self-sustaining solution for the healthcare providers practice * Assist healthcare providers to document accurately and code to the highest level of specificity in order to capture a members true health status at the time of care * Query providers to obtain additional medical record documentation or to clarify documentation to ensure accurate and appropriate coding * Perform chart review and identify previously accepted/undocumented conditions to accurately report patients true health status * Demonstrate analytical and problem-solving ability with regard to barriers in receiving and validating accurate HCC information * Perform targeted audits of charts based on system generated reports with special screening criteria and be able to communicate findings clearly and concisely, orally and in writing * Support and participate in process and quality improvement initiatives * Take responsibility and ownership of coding projects as assigned. Work with other team members and ensure completion with appropriate speed and expected accuracy * Keep current on all governmental medical and legal issues specific to coding and compliance. * Responsible for sharing knowledge of issues with Medicare Risk Adjustment Manager * Attends seminars and in-services as required to remain current on coding issues * Other duties as assigned. Role Essentials * Minimum of 3 years HCC documentation and coding review experience * CPC certification is required * Strong interpersonal skills including: effective communication, listening and professionalism, problem-solving and team-building skills, self-management, responsibility and accountability * Attention to detail * Strong analytical skills * Proficient in the use of MS Office * Knowledge of EMR for reviewing records * Experience in provider setting Role Desirables * Other certifications as follows - CPCI (Certified Professional Coder-Instructor), CPMA (Certified Professional Medical Auditor), HIM (Health Information Management), CCS (Certified Coding Specialist), CCS-P (Certified Coding Specialist-Physician), RHIT (Registered Health Information Technician), RHIA (Registered Health Information Administrator), Billing certification At Humana, were also committed to making the resources available to you that will enable you to become happier, healthier, and more productive in all areas of your life. We know your well-being is important to you, and its important to us too. If you share our passion for helping people, we likely have the right place for you at Humana. After applying, we encourage you to join our Talent Network as well, so you can stay informed and up to date on whats happening around our organization in the changing world of healthcare. 1 day ago - save job - original job Apply On Company Site Other jobs you may like Risk Adjustment Coding Auditor GlobalHealth - Oklahoma City, OK 30+ days ago Risk Adjustment Coding Auditor GlobalHealth LLC - Oklahoma City, OK 30+ days ago Easily apply Benefits Adjuster Mosaic Personnel - Oklahoma City, OK 30+ days ago Easily apply Rep, Benefits Adjuster I American Fidelity Assurance - Oklahoma City, OK 8 days ago * Jobs at Humana in Oklahoma City, OK Humana Humana 4,097 reviews For more than 50 years Humana has been a proven leader and innovator in the health and wellness industry. A passionate emphasis on people,... Let employers find you Thousands of employers search for candidates on Indeed Upload Your Resume