Risk Adjustment Department is looking for top skilled Quality Assurance Coding Specialist. Is that you?
Work location: Southwestern Health Resources Headquarters, 1601/1603 Lyndon B. Johnson Freeway, Farmers Branch, TX 75234.
Work environment: Risk Adjustment Department.
Please note: The Quality Assurance Coding Specialist will be an employee of Southwestern Health Resources (SWHR). SWHR is a clinically integrated network formed by Texas Health Resources (THR) and University of Texas Southwestern Medical Center (UTSW).
Work hours:
Full-time, 40 hours per week.
Monday - Friday, Day shift.
This is a Hybrid position, to be based in North Texas/Dallas Fort Worth area, requiring occasional onsite workdays, based on department business needs.
In-person attendance required at department meetings, trainings and/or other department authorized activities, at the above-mentioned address or other locations as directed by the department management.
Organization Highlights
Southwestern Health Resources (SWHR) is a patient-centered, clinically integrated network of 29 hospital locations and more than 6,900 physicians and clinicians caring for more than 730,000 patients across 16 counties in North Texas. Blending the strengths of Texas Health Resources and the University of Texas Southwestern Medical Center, SWHR offers an unmatched ability to connect individuals with a full spectrum of nationally preeminent, clinical care. SWHR is the parent of Care N' Care Insurance Co., a leading regional Medicare Advantage health plan providing care to over 12,000 members.
At SWHR, we believe healthcare can be more integrated, accessible and affordable for all. Our purpose: to build a better way to care, together. Our promise: to simplify and empower care, for good.
Here's What You Need
Education
Bachelors Degree required.
Associates degree or 3 years of additional experience in lieu of Bachelor's degree required.
High School Diploma or Equivalent required or 2 years' additional experience in lieu of Associate's Degree required.
Experience
Require 1 year of Hierarchical Condition Category (HCC) coding and documentation experience with Bachelor's degree, or,
Require 3 years of HCC coding experience with Associate degree, or,
Require 5 years of HCC coding experience with High School Diploma or Equivalent.
Licenses and Certifications
Require a current Certified Professional Coder (CPC) Certification or Certified Coding Specialist (CCS) Certification from the American Academy of Professional Coders (AAPC).
Highly prefer Certified Risk Coder Certification.
Skills & Abilities
Strong organizational skills in multiple settings, as well as the ability to exercise sound judgment and initiative.
Strong presentation skills.
Excellent problem-solving and the ability to handle multiple projects, heavy workloads, and deadlines in a fast=paced dynamic environment.
Self-motivated with excellent follow-through skills with the ability to work independently with minimal to moderate supervision with demonstrated ability to work as an effective team member.
Strong working knowledge of MS Office products, including PowerPoint, Excel, and Word.
Ability to think strategically to develop new initiatives/processes that will achieve our specified targets.
Ability to motivate the team and hold the team accountable for the results.
Ability to work effectively as a interdisciplinary team as well as independently.
Excellent knowledge of HCC coding and documentation.
What You Will Do
Position Responsibilities and Functions
Responsible for auditing assigned coders work and providing weekly feedback.
Weekly individual coaching sessions required with any QA score of less than 95%.
Interactive training sessions with assigned coding team; minimum bi-weekly cadence.
Analyze QA data for patterns and trends to identify opportunities to improve internal coding education and performance.
Subject matter expert on all internal coding questions.
Collaborate with Education/QA leadership on updating internal coding resources and tools.
Participate in all HCC training within the RAF department.
Why Southwestern Health Resources
As a Southwestern Health Resources employee, you'll enjoy, comprehensive benefits, including a 401(k) with match; paid time off; competitive health insurance choices; healthcare and dependent care spending account options; wellness programs to keep you and your family healthy; tuition reimbursement; a student loan repayment program; and more.
Additional perks of being an SWHR employee:
Gain a sense of accomplishment by contributing to a teamwork environment.
Positively impact patients' quality of life.
Receive excellent mentorship, comprehensive training and dedicated clinical and administrative leadership resources.
Enjoy opportunities for growth.
Explore Southwestern Health Resources Careers for more information and to search all career opportunities.
Our Recruitment team invites you to contact us with any questions at recruitment@texashealth.org
