Position Purpose

The Clinically Integrated Network (CIN) Risk Coding Specialist is responsible for reviewing medical records to assess clarity, completeness, and coding accuracy of the diagnoses documented and billed for patients attributed to our value-based, risk-bearing contracts.

What you will do

Serve as an expert in risk coding, demonstrate a solid understanding of ICD-10-CM coding, medical terminology, Hierarchical Condition Categories (HCCs), and M.E.A.T. (Monitor, Evaluate, Assess/Address, Treat) documentation standards in order to accurately code to the most appropriate level of specificity

Exercise thorough understanding of ICD-10-CM coding guidelines, payor regulations, compliance and reimbursement, and the effects of coding in relation to risk adjustment payment models

Conduct chart review audits, identify coding and/or documentation discrepancies, and prepare feedback, education, and recommendations to providers to correct charting deficiencies or coding errors

Utilize array of reports available to prioritize patients needing follow up, identify suspect conditions and HCC gap opportunities, and prepare charts in advance of visits to optimize provider review of conditions

Minimum Qualifications

Current active Certified Risk Coder (CRC) certification required

Minimum three years experience in healthcare setting, with at least one year working in an ACO or similar organization holding value-based, risk arrangements

Strong interpersonal communication and customer service skills, especially in relation to engaging with physicians and other healthcare professionals; experience providing feedback, education, and recommendations to clinicians

Position Highlights and Benefits

Full time 40hrs M-F

Excellent benefits starting day 1

Ministry/Facility Information

Trinity Health Of New England is an integrated health care delivery system comprised of world-class providers and facilities dedicated to the full spectrum of preventive, acute, and post-acute care, all delivered with the triple aim of better health, better care, and lower costs for our patient populations

Our Commitment to Diversity and Inclusion
 

Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.