Clinical Coder Analyst - Ryan Health | West 97th Street
Clinical Coding Analyst supports and enhances Ryan Health’s Population Health Department by supporting efforts to maximize risk adjustment, reimbursement, and quality incentive payments through quality coding. This position will be familiar with all aspects of New York State
Medicaid and CMS guidelines for clinical coding in a federally qualified health center (FQHC) setting.
- As related to clinical coding, develops, generates and presents data to maximize performance for Ryan Health’s Population Health efforts; develops reporting and analyses to support strategic and contractual requirements for internal and external stakeholders.
- Analyzes and collates Ryan Health and payor data related to risk scores, modifiers, diagnostic and procedure coding; identifying potential discrepancies and areas for improvement.
- Under direction of Associate Director of Population Health and Director of Care Management, assists with development of programs aimed to improve documentation of patient risk and reimbursement using HCC codes, CRG codes, Annual Wellness Visits, etc.
- Collaborates with Population Health, IT, and Billing Department team members to develop dashboards, workflows, and other tools to support Network’s performance and culture of continuous quality improvement.
- Develops and provides support and education related to diagnosis and procedure coding and documentation, including training sessions to staff (including providers)
- Reviews and adjusts denied claims with coding issues for resubmission, as requested by Population Health leadership.
- Acts as liaison with payors and other external parties to resolve coding issues
- Retrieves electronic medical record from eClinicalWorks (eCW) to verify and ensure accuracy, completeness, specificity, and appropriateness of diagnoses and CPT codes
- Researches and prepares for any changes and/or additions to coding tables and procedures to ensure coding/risk adjustment efficacy
- Immediately report any problems or unusual occurrences to supervisor.
- Other special projects/assignments as needed.
Minimum Experience and Skills Required:
- 2 years' experience in medical coding and data entry in an outpatient setting
- 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 system(s)
- Strong communication and interpersonal skills
- Strong knowledge of Microsoft Office Suite (notably Excel)
- AAPC Certified Risk Adjustment Coder (CRC) or AAPC Certified Coding Specialist (CCS)
- Associate’s or bachelor's degree
- Experience in FQHC setting
- Experience with eCW
- Experience in Quality Improvement or Population Health programs
- Professional, courteous and respectful attitude in dealing with patients.
- Demonstrates the knowledge and skills necessary to provide care appropriate to the age of the patient served (if applicable).
- Commits to exceeding expectations of the patient.
- Works well with others.
- Contributes input to improve outcomes.
- Asks others for opinions and feedback; provides feedback in a tactful respectful way;
Minimal Training Time:
180 actual workdays introductory period
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is frequently required to sit, stand, talk and hear.
The employee is occasionally required to move about the office; use hands and fingers to feel, handle, or operate office equipment.
Specific vision abilities required by this job include close vision and the ability to adjust focus.
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The work is primarily in a mental health clinic and/or general primary care setting which includes the unpredictability in behaviors of individuals and acute and chronic infectious diseases which may be contagious. Adequate preparation and precaution is necessary.
The duties listed above are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar, related or a logical assignment to the position. This position may be required to perform other duties. If such work becomes a permanent and regular part of the job, a new description will be prepared.
Equal Opportunity Employer
Ryan Health is an Equal Opportunity / Affirmative Action Employer and does not discriminate because of age, color, disability, ethnicity, marital or family status, national origin, race, religion, sex, sexual orientation, gender identity, military veteran status, or any other characteristic protected by law. We are committed to attracting, retaining and maximizing the performance of a diverse and inclusive workforce.