Value Based Coder II

The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric, full-service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Health’s Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, health plans and employers with a business objective to excel in coordinating patient care in a manner that supports containing costs while continually improving quality of care and levels of service. Dignity Health MSO accomplishes this by capitalizing on industry-leading technology and integrated administrative systems powered by local human resources that put patient care first.

Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art, flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options, including medical, dental and vision plans, for the employee and their dependents, Health Spending Account (HSA), Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave.

Arizona Care Network (ACN) is a clinically integrated physician network and is a Dignity Health and Abrazo Health (Tenet) physician collaboration. The Value Based Coder is an employee of Inland Health Organization of Southern California, Inc., doing business as Dignity Health Managed Services Organization, a physician support organization owned by Dignity Health.

***This position is hybrid in-office and work from home.

Position Summary:

Arizona Care Network (ACN) is a clinically integrated physician network and is a Dignity Health and Abrazo Health (Tenet) physician collaboration. The Value Based Coder is an employee of Inland Health Organization of Southern California, Inc., doing business as Dignity Health Managed Services Organization, a physician support organization owned by Dignity Health.

As a member of the Clinical Performance team, the Value Based Coder II works with providers and office staff across the network to identify opportunities for improved quality, risk adjustment coding performance. The Value Based Coder II is a valuable resource in process improvement and identifying clinically appropriate risk adjusting conditions to capture.

Responsibilities may include:
- Review patient medical record information via population health tools on both a retroactive and prospective basis to identify, assess, monitor and review coding opportunities.
- Ensure that the diagnosis codes for each chronic or major medical condition have been captured and work to educate providers on opportunities to improve documentation on medical conditions.
- Review clinical documentation across the network to identify patterns and trends in clinical documentation. Work with network providers to improve clinical documentation to better support CMS Risk Adjustment guidelines.
- Develop education materials and tools to help network providers improve clinical documentation.
- Participate network performance improvement initiatives.
- Safeguards medical records and preserves the confidentiality of personal health information through the observance of physician network policies pertinent to the release of medical record information, record retention, and HIPAA privacy and security.

Minimum Qualifications:

- Familiarity and understanding of CMS HCC Risk Adjustment coding and data validation requirements.
- Knowledge of federal and state guidelines on all coding systems and sponsored programs.
- Associates degree in healthcare or equivalent experience.

- Must possess the ability to work independently with strong organizational, communication and interpersonal skills to support the management of multiple priorities, at multiple practice locations, with significant attention to detail for completion of both verbal and written external communications.

- Computer literacy of medical information system, records management software, encoders. Proficiency in MS office (outlook, excel, word).

Preferred Qualifications:

- 2-3 years of experience in outpatient and/or HCC/risk adjustment coding preferred.

- Certified Risk Adjustment Coder (CRC) or Certified Professional Coder (CPC) strongly preferred.