May 09, 2019
Under general direction from the Quality Assurance Manager or Clinical Quality Coding Director, delivers Comprehensive Health Assessment programs, including Medicare Advantage Hierarchical Condition Categories (HCC) Clinical Quality Coding Program. Trains and educates coding staff and providers on documentation and accurate reporting of ICD-10-CM diagnoses codes, documentation to support assignment and reporting of diagnosis(es) codes, including Hierarchical Condition Category (HCC) Risk Adjustment model. Partners with Clinical Quality Coding Leads, the Clinical Quality Coders and the Clinical Quality Coding Manager to support coding compliance and provide feedback of observations that are identified and trended by the Clinical Quality Coding Quality Assurance team.
+ Bachelors Degree preferred or equivalent education/experience
**Licensures and Certifications**
+ Certified Professional Coder (CPC), Certified Coding Specialist - Professional (CCS_P), and/or Certified Coding Specialist (CCS) required
+ Certified Risk Adjustment Coder (CRC) 1 Year required
+ 6-9 years professional coding experience required.
+ Proficient use of grouper software and/or coding reference books to assign/validate diagnosis codes required.
+ 3-5 years experience creating and delivering coding education to certified coders and clinicians required.
**Skills and Knowledge**
+ Advanced knowledge of ICD-10 diagnosis coding conventions and requirements, knowledge of Quality Coding requirements such as the Medicare Advantage Coding/HCC, as well as medical terminology and abbreviations of disease, illness and injury process.
+ Proficient use of grouper software and/or coding reference books to assign/validate diagnosis codes.
+ Knowledge of APC and DRG assignment logic, National Correct Coding Initiative edits, Coding Clinic and CPT Assignment coding guidelines and the contents of a medical record required.
+ The ability to work at a fast pace and maintain a high concentration level with accuracy is essential.
+ Demonstrated verbal and written communication skills.
**Organization:** Sutter Health System Office
**Employee Status:** Regular
**Position Status:** Exempt
**Job Shift:** Day
**Shift Hours:** 8 Hour Shift
**Days of the Week Scheduled:** Monday-Friday
**Weekend Requirements:** Other
**Schedule:** Full Time
**Hrs Per 2wk Pay Period:** 80
All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, marital status, sexual orientation, registered domestic partner status, sex, gender, gender identity or expression, ancestry, national origin (including possession of a driver's license issued to individuals who did not present proof of authorized presence in the U.S.), age, medical condition, physical or mental disability, military or protected veteran status, political affiliation, pregnancy or perceived pregnancy, childbirth, breastfeeding or related medical condition, genetic information or any other characteristic made unlawful by local, state, or federal law, ordinance or regulation. External hires must pass a background check/drug screening. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state, and local laws, including but not limited to the San Francisco Fair Chance Ordinance.