Medical Quality Coder/Auditor

  • Address

    Vista, CA, 92081

  • Type of position

    Admin/Support

  • Posted on

    December 31, 1969

Vista Community Clinic is hiring for a Medical Quality Coder/Auditor job in Vista,CA

Overview

Vista Community Clinic is a private, non-profit multi-specialty outpatient clinic.  Providing care in a comprehensive, high quality setting.  Located in San Diego, Orange and Riverside counties, we work to advance community health and hope by providing access to premier health services. We work to advance community health and hope by providing access to premier health services and education for those who need it most.  We are looking for dedicated, motivated, enthusiastic team players who want to serve our population. Every day, you will make an impact on the community, touching lives of others.  We have a very competitive compensation and benefits program which includes health, dental, vision, company-paid life, AD&D & disability insurance, flexible spending accounts and a 403(B) plan, for eligible employees.  VCC is an equal opportunity employer.

Responsibilities

  • Responsible for system wide requirements for accuracy in documentation to include ICD-10 and CPT codes, ensuring Quality Measures and Preventive services are completed for patients required by Managed Care, CMS, and Medicare Advantage guidelines
  • Collaborate with IT and other departments as needed to ensure appropriate ICD-10 and CPT codes are updated annually in Electronic Medical Records (EMR) system
  • Identify opportunities for improvement and apply appropriate process improvement methodologies
  • Review patient medical records for HEDIS measures determined by the organization
  • Accurately audit and review diagnoses codes to ensure highest level of specificity
  • Accurately audit and review CPT procedures for appropriate services
  • Review and update encounter documents on a continuous basis, ensuring completeness and accuracy with identification of problem trends affecting HCC, communicate correct coding to Clinicians
  • Assist in the development of training materials with Clinical Quality Manager and staff
  • Assist Clinical Quality Manager and staff in writing/establishing operating procedures to meet coding regulations/compliance and follow-up enhancement

Qualifications

Minimum

  • High school graduate or equivalent
  • Coding certification, preferably HCC Coder (Certification from AHIMA and/or AAPC)
  • Minimum three years' medical coding experience
  • Minimum two years' medical auditing experience
  • Coding compliance program implementation experience
  • Knowledge of Quality metrics and HEDIS
  • Proficient ion Microsoft suite of products:  Excel, Outlook, Word, PowerPoint

Preferred

  • Two years' experience in an FQHC environment
  • Experience with NextGen
  • Coding compliance program implementation experience

Required Skills/Knowledge/Abilities

  • Knowledge of  Medicare, Medi-Cal/Presumptive Eligibility, FPACT, Every Woman Counts, Tricare and Managed Care Payors
  • Knowledge of payor coding policies and guidelines for FQHC’s
  • Familiar with medical terminology
  • Strong data entry skills
  • Ability to perform a high volume of detail work with speed and accuracy
  • Ability to communicate initiatives, results and analyses, to multiple levels of management

  • Contact Information :
  • Vista Community Clinic,
  • ,
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