Location: College Station,TX, USA
Job Title
Risk Adjustment Consultant
Agency
Texas A&M University Health Science Center
Department
Rural And Community Health Institute
Proposed Minimum Salary
Commensurate
Job Location
College Station, Texas
Job Type
Staff
Job Description
Our Commitment
Texas A&M University is committed to enriching the learning and working environment by promoting a culture that respects all perspectives, talents & lived experiences. Embracing varying opinions and perspectives strengthens our core values which are: Respect, Excellence, Leadership, Loyalty, Integrity, and Selfless Service.
Who we are
As one of the fastest-growing academic health centers in the nation, Texas A&M Health encompasses five colleges and numerous centers and institutes working together to improve health through transformative education, innovative research and team-based health care delivery.
What we want
The Risk Adjustment Consultant works with rural healthcare providers to provide expertise, guidance, technical assistance, and education for healthcare professionals in regard to Hierarchical Condition Category (HCC) risk adjustment coding. This role creates strategies and initiatives to improve HCC risk adjustment coding, quality of care and financial viability. The Risk Adjustment Consultant serves as the subject matter expert to manage and promote improved risk adjustment capture, efficiencies, and processes.
What you need to know
Schedule: This position requires up to 20% or more of travel.
Location: This position may allow an alternate work location (within the State of Texas) per TAMU guidelines.
Please note: This position is grant funded; future employment may be contingent upon future funding.
Required Education and Experience:
* Bachelor's degree in health, education, business, or related field and successful completion of an accredited medical coding program.
* Required Experience
* Three years of related experience in coding, with a minimum of two years of experience in Risk Adjustment and Hierarchical Condition Category (HCC) coding in a healthcare setting, or closely related area of medical coding. An equivalent combination of education and experience may be considered.
Required Licenses and Certifications:
* Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) or equivalent certification.
Preferred Qualifications:
* Certified Risk Adjustment Coder (CRC) or other related certification. Five or more years of experience in Risk Adjustment and HCC coding in a healthcare setting, including supervisory/leadership experience.
Knowledge, Skills, and Abilities:
* Working knowledge and understanding of ICD-10-CM coding guidelines and CMS-HCC risk adjustment methodology.
* Familiarity with electronic health record (EHR) systems and medical coding software.
* Excellent attention to detail, analytical skills, and ability to work independently.
* Strong communication skills and interpersonal skills for collaboration with medical professionals and team members.
* Understanding of compliance and confidentiality regulations, including HIPAA.
Responsibilities:
Consultant Services
* Reviews medical records and encounters for diagnoses and procedures related to Risk Adjustment and HCC coding guidelines providing queries and guidance to diagnosing physicians.
* Monitors accurate, timely, and complete documentation of medical conditions and treatment in patient records to ensure compliance with HCC coding.
* Performs reviews of records to determine complete, accurate documentation of patient condition and treatment.
* Queries and/or presents findings to clinicians, when appropriate.
* Demonstrates ability to recommend proficient queries to practitioners or support staff regarding missing, unclear, or conflicting health record documentation to obtain additional documentation within the health record as needed.
* Develops improvement action plans based on review activities and leads implementation of these action plans.
* Appropriately escalates provider non-responses or inappropriate responses for reconciliation.
* Collaborates with clinic teams and clinicians to reconcile potential documentation and coding opportunities.
Performance Improvement and Strategic Review
* Collaboratively works with interdisciplinary teams including, but not limited to health care providers, patient safety staff and health information improvement teams.
* Develops and/or provides ongoing education and information regarding documentation opportunities to practitioners, coders, and other stakeholders.
* Promotes related education to others such as allied health professionals, administration, coordinators, and other teams.
* Formulates, interprets, and analyzes data relative to opportunities to improve HCC risk adjustment capture and documentation?practices.
* Formulates metric-based documents for senior leadership and medical staff groups/divisions as it relates to HCC risk adjustment coding activities and improvement plans.
* Serves on committees and meetings relating to risk coding capture along with functioning as a subject matter expert and problem solver.
* Works directly with physicians and is a liaison for physician and administrative meetings providing consultative guidance and support.
Regulatory Awareness and Trends
* Ensures methods are up to date with the latest coding guidelines, rules, and regulations related to Risk Adjustment and HCC coding.
* May train and audit clinic teams including physicians and coders.
* May provide webinars and other means of communication in regard to HCC changes and trends.
* Performs other position appropriate duties as required in a competent, professional and courteous manner.
Why Texas A&M University?
We are a prestigious university with strong traditions, Core Values, and a community of caring and collaboration.? Amenities associated with a major university, such as sporting and cultural events, state-of-the-art recreation facilities, the Bush Library and Museum, and much more await you.? Experience all that a big city has to offer but with a reasonable cost-of-living and no long commutes.
* Medical, prescription drug, dental, vision, life and AD&D, flexible spending accounts, and long-term disability insurance with Texas A&M contributing to employee health and basic life premiums
* 12-15 days of annual paid holidays
* Up to eight hours of paid sick leave?and at least?eight hours of paid vacation?each month
* Automatically enrollment in the?Teacher Retirement System of Texas
* Health and Wellness: Free exercise programs and release time
* Professional Development: All employees have access to free?LinkedIn Learning?training, webinars, and limited financial support to attend conferences, workshops, and more
* Educational release time and tuition assistance?for completing a degree while a Texas A&M employee
* Living Well, a program at Texas A&M that has been built by employees, for employees
Instructions to Applicants: Applications received by Texas A&M University must either have all job application data entered, or a resume attached. Failure to provide all job application data or a complete resume could result in an invalid submission and a rejected application. We encourage all applicants to upload a resume or use a LinkedIn profile to pre-populate the online application.
All positions are security-sensitive. Applicants are subject to a criminal history investigation, and employment is contingent upon the institution's verification of credentials and/or other information required by the institution's procedures, including the completion of the criminal history check.
Equal Opportunity/Affirmative Action/Veterans/Disability Employer.