CLINICAL CODER ANALYST

OUR VISION

To continue as an eminent healthcare provider on Long Island, dedicating ourselves to providing exceptional health care for all our patients and to transform both the lives of the individual, and the community, for the better, one person at a time.

OUR MISSION

To provide access to equitable, optimal healthcare by improving the overall wellness of all individuals in our communities and delivering high quality comprehensive patient centered care.

OUR VALUE PROPOSITION

To provide whole person care that will ensure that all patients have access to primary, specialty and social health care to achieve and maintain optimal wellness at a transparent and affordable cost.

JOB TITLE:  Clinical Coding Analyst 

REPORTS TO:  Assistant Director of Patient Revenue Cycle 

The following statements reflect the general duties, responsibilities and competencies considered necessary to perform the essential functions of the job and should not be considered as a detailed description of all the work requirements of this position.  

ESSENTIAL FUNCTIONS:

• Develops and provides support and education related to diagnosis and procedure coding and documentation, including training sessions for staff (including providers).
• Retrieves electronic medical records from eClinicalWorks (eCW) to verify and ensure accuracy, completeness, specificity, and appropriateness of diagnoses and CPT codes.
• Review and adjust denied claims with coding issues for resubmission.
• Work with payers and other external parties to resolve coding issues.
• Collaborates with various departments and team members to develop workflows and other tools to support HHLI performance and culture of continuous quality improvement.
• As related to clinical coding, develops, generates, and presents data to maximize coding and documentation efforts, 
• Develops reporting and analyses to support strategic and contractual requirements. ?
• Analyzes and collates HHLI and payer data related to risk score, modifiers, diagnostic, and procedure coding, identifying potential discrepancies and areas for improvement. 
• Support efforts to maximize risk adjustment, reimbursement, and quality incentive payments through quality coding.
• Researches and prepares for any changes and/or additions to coding/risk adjustment efficacy.
• Knowledge of all aspects of New York State Medicaid and CMS guidelines for clinical coding in a federally qualified health center (FQHC ) setting.
• Immediately report any problems or unusual occurrences to the supervisor.
• Other special projects/assignments as needed. 

QUALIFICATIONS:

• 2 years’ experience in medical coding and data entry in outpatient setting
• 2 years of experience, or expertise, in evaluation and management coding is required
• Certified Professional Coder (CPC)
• High School Diploma or equivalent. 
• Must have a thorough knowledge of CPT/HCPCs and ICD-10 coding and medical terminology
• Experience with electronic medical record systems
• Strong communication and interpersonal skills
• Strong knowledge of Microsoft Office Suite (notably excel).
• AAPC Certified Risk Adjustment Coder (CRC) 
• Certified Professional Medical Auditor (CPMA) desirable
• Experience in FQHC Setting, Preferred
• Experience with eCW, Preferred
• Experience in Quality improvement or Population Health Programs

COMPETENCIES REQUIRED:

Customer Service:

• Professional, courteous, and respectful attitude in dealing with staff, including clinical staff
• Commits to exceeding expectations. 

Cooperation/Teamwork

• Contributes input to improve outcomes.
• Ask others for opinions and feedback; provides feedback in a tactful respectful way.

REQUIREMENT:

• Ability to drive or reliable means of transportation. 
• This is a hybrid position. To be considered for this role, you must reside in the NYC or Long Island area.

SALARY: Commensurate with experience

MORE INFORMATION: This is a non-exempt position. 

The Harmony Healthcare Long Island provides equal employment opportunities to all qualified individuals without regard to race, creed, color, religion, national origin, age, gender, marital status, sexual preference and orientation, or non-disqualifying physical or mental handicap/disability in each aspect of the human resources function. Applicants, as well as employees who are or become disabled, must be able to perform the essential job functions either unaided or with reasonable accommodation. The Harmony Healthcare Long Island shall determine reasonable accommodation on a case-by-case basis in accordance with applicable law.