Do you enjoy working with friendly and helpful people in a positive work environment? Are you ready to embrace a career that offers a variety of learning opportunities? Are you looking to make a positive impact on peoples' lives in our community?

Consider a career at Boulder Medical Center (BMC). We are 100% privately owned and Physician operated, we provide care in over 20 different specialties, have 90+ providers practicing today, we employ 325+ Healthcare Professionals, and we have locations through-out Boulder County, CO.

Summary:

Boulder Medical Center (BMC) is currently seeking Certified Medical Coders to join our Quality team as a Risk Adjustment Coding Specialist! This position will work full-time 40 hours per week on Monday through Friday with the flexibility to work remotely.

Job Perks:

• Full-time employees are eligible for medical / dental / vision, flexible spending, company-paid life insurance and Short Term Disability (STD) as well as several voluntary benefit options, RTD EcoPass, 401(k), Paid Time Off (PTO) and six (6) paid holidays annually.
• Part-time employees are eligible for medical / dental / vision, company-paid life insurance, voluntary benefits, RTD EcoPass, 401(k), and holiday pay (if regularly scheduled to work on an observed holiday).

Job Duties:

• Regulatory oversight and quality assurance
  • Provides regular, specialized coding classes for providers & medical staff to ensure correct and accurate risk adjustment coding.
  • Works and coordinates with outside coding consultants regarding risk assessment and HCC coding as needed and maximizes the impact to BMC of such consultations
  • Provider Engagement, training and support
    • Conduct ongoing training and education for new hire and current providers related to the HCC Risk Adjustment Process, proper medical record documentation, and diagnosis accuracy.
    • Collaborate with Quality Program Supervisor and payer partner representatives to understand quality initiatives and the relationship of risk adjustment to current metrics and incentive payments under these programs.
    • Collaborate with supervisor to project and monitor the impact of coding programs on revenue from CMS and other payers for budgets and plans. Performs all duties in accordance with business practices and approaches unique to BMC and their group practice status.

Coding

• Confirm all risk adjustment diagnosis codes from acceptable provider documentation and in accordance with industry standards, CMS or HHS Risk Adjustment Guidelines
• Adherence to current industry standard as defined in the ICD-10 guidelines for coding and correct reporting
• Confirm accurate entry of risk adjusted codes into internal/external data bases as defined by State, Federal or other regulatory agencies.
• Identify and apply best practices to ensure accuracy of risk adjustment coding is consistent across all payer partners
• Reconcile data to outcomes and risk scores and trending patters to RAF scores
• Monitor risk adjustment-related activities including but not limited to risk adjustment program payments, encounter data submission and return files to ensure all tasks are completed in a timely manner and achieve expected outcomes

• Must be knowledgeable about Compliance/HIPAA rules and regulations.
• Ability to coach, orient and mentor staff by demonstrating effective analytical and leadership skills;
• Possess effective and collaborative interpersonal, communication and problem-solving skills and an ability to work within teams and within a dynamic work environment;
• Uses good judgment to anticipate and assess training needs;
• Must be able to set priorities and take initiative to effectively coordinate all coding activities associated with quality programs.
• Must be able to multi-task, be flexible and detail-oriented with focus on strategy, analysis, planning and organizing to achieve quality improvement goals
• Proficient computer application skills in Microsoft Office products to include Word, Excel and PowerPoint.
• Familiarity with programs such as Electronic Health Records and vendor portals.
• Extensive knowing in medical terminology and ability to research coding-related questions

Education:

• High school diploma. Some college, preferred.
• Certified Risk Coder (CRC) required
• Certified Professional Coder (CPC) preferred.
• 2 years minimum experience with chart audit and medical coding preferred.
• Hierarchical condition category (HCC) coding experience desired.

Previous Experience:

• Prefer 2-3 years of prior experience in healthcare practice or health plan operations.
• Previous experience in risk adjustment coding activities in Medicare, ACA or provider organization with knowledge of CMS, State and other regulatory guidelines.

Salary Range:

• 
  $22.16 - $29.92 / per hour; depending on experience.

• Boulder, CO
• This position has flexibility to work remotely.
  
• Applicants must maintain a Colorado residency.

BMC offers a comprehensive benefit package for full-time employees that includes medical/dental/vision, flexible spending, company-paid life insurance and STD as well as voluntary benefits, RTD EcoPass, 401(k), Paid Time Off and 6 holidays annually. Part-time employees are eligible for medical/dental/vision, company-paid life insurance, voluntary benefits, RTD EcoPass, and 401(k).

From: Boulder Medical Center