HCC Coder III

Arizona Priority Care (AZPC) is an Integrated Provider Network focused on providing whole-person care to Senior and Medicaid populations, through advanced value-based models. Our provider network is comprised of more than 6,000 health care providers, including primary and specialty care physicians, hospitals and ancillary providers. We have operated in the Arizona market for more than 12 years, based in Chandler, Arizona, and are an affiliate of Heritage Provider Network. As a leading value-based provider organization, we are committed to improving the quality of care, providing excellent member and provider experiences all while reducing cost.

The HCC Coder III is a highly organized and analytical individual, possessing effective communication skills, with extensive knowledge of documentation requirements and official coding conventions and rules for appropriate coding based on CMS HCC-Risk Adjustment Model. The HCC Coder III is responsible for ensuring that provider documentation meets regulatory compliance and that all diagnoses are reported completely and accurately.

POSITION DUTIES & RESPONSIBILITES

• Conduct retrospective and concurrent year chart audit to identify documentation improvement opportunities for education in alignment with AZPC HCC Provider Education department initiatives.
• Accurately follows ICD-10-CM coding and reporting guidelines according to established AZPC coding policy.
• Perform internal coding quality audits.
• Identify proper billing procedures. Identify deficiencies and educate accordingly.
• Identify areas in need of correction or education by applying the compliance review process.
• Implement a plan for compliance and maximizing coding and reporting of chronic conditions.
• Develop and maintain provider relationships and serve as a primary source for provider education.
• Conducts one-on-one and group educational sessions for providers and staff.
• Communicate effectively with providers in a tactful manner and under difficult situations.
• Conduct face-to-face meetings with providers and office staff to present plan, and to track progress.
• Work closely with Physician Educators, Provider Relations and other internal departments as necessary.
• Query providers in an ethical manner and track results.
• Perform coding work requiring independent judgment with speed and accuracy and accomplish assigned work in a timely manner.
• Keep current on all government medical and legal issues specific to coding and compliance.
• Participate as needed in training and educational opportunities.
• Other duties and special projects as assigned.

EDUCATION, TRAINING AND EXPERIENCE

• AAPC/AHIMA coding certification required.
• Five years of diagnostic and procedural coding experience or three years HCC coding,
• Prior auditing experience required.
• Prior experience in a medical office and presenting audit findings and recommendations preferred
• Advanced knowledge in Medical Terminology, Anatomy and Physiology, and Pathophysiology of Diseases
• Proficiency with MS Office as well as intermediate skills in Excel and Word
• Valid Arizona driver’s license and proof of insurance

*This role requires FT in-office presence for the first 60 days of employment. Hybrid schedule available after initial training period.*