[Hiring] Consultative Coding Professional @427 CDO 2, LLC
Mar 26, 2025 - 427 CDO 2, LLC is hiring a remote Consultative Coding Professional. 💸 Salary: $59,300 - $80,900 per year. 📍Location: USA.
Role Description
Become a part of our caring community and help us put health first. The consultative coder confirms appropriate diagnosis and procedural code assignment. Responds to internal requests for coding and/or documentation related information. Follows established guidelines/procedures. Decision making on moderately complex to complex issues. Provides support to clinic staff and providers. Requires minimal guidance, receiving guidance when needed.
The Consultative Coder provides medical coding expertise to support clinical staff (Physicians and Advanced Practice Providers) to ensure the documentation within medical records supports diagnostic and procedural coding.
- Cultivate relationships with Physicians and Advanced Practice Providers to serve as the single point of contact for questions and issues relating to documentation and coding.
- Identify documentation improvement areas and partner with clinical and coding education to deliver education related to improvement opportunities.
- Analyze trends, triage, and answer questions in real-time.
- Research and interpret correct coding guidelines and internal business rules to respond to inquiries and issues.
Perform Quality Assurance on post-visit reviews (Frequency and sampling methodology to be determined).
- Review the encounter for potential missed opportunities.
- Address nonbillable services at the provider level.
- Address documentation deficiencies resulting in not billable services in a timely manner (missing chief complaint, missing time for audio only visits, and missing telehealth platform).
- Serve as liaison to provide timely updates on documentation requirements and process changes.
Responsible for the special handling of Mergers & Acquisitions:
- Perform Problem list cleanup (as outlined by compliance).
- Conduct PCO Process training including but not limited to reporting for open notes and addendums, and gap attestation process and performance expectations.
- Train acquired providers on PCO documentation requirements and processes.
Lead Special Projects within the Division/Markets as requested by Market leaders, perform the following duties:
- Summarize and analyze AWV completion rates (what criteria is needed to complete AWV).
- Analyze EDAPS; report the variances between datahub and eCW.
- Conduct Chart reviews to identify educational opportunities.
- Perform individual chart research as requested.
- Collaborate with HEDIS leaders and champions to identify HEDIS gaps and deficiencies.
- Participate in Payer calls/chart reviews.
- Compile payer findings and assist with research.
- Participate in payor meetings/discussions to ensure accurate data submission.
Qualifications
- A minimum of three years of technical Medical Coding, focused on outpatient (risk adjustment) coding.
- RHIA, RHIT, CCS, or CPC Certification.
- Ability to travel both locally and overnight.
- Comprehensive knowledge of all Microsoft Office applications, including Word, Excel, and PowerPoint.
- Ability to communicate effectively and sensitively with clinicians and team members in stressful situations.
- Possess strong business acumen, excellent strategic thinking, and effective critical thinking skills.
- Excellent verbal and written communications skills with demonstrated ability to communicate, present, and influence both credibly and effectively at all levels of an organization.
- Ability to work in a rapidly changing, matrixed environment.
- Has a positive, collaborative mindset to foster partnership within and the Coding, Audit, and Education department, the PCO, and Humana.
Requirements
- Passionate about contributing to an organization focused on continuous improvement.
- Proficient verbal and written communication skills.
- Public speaking / group presentation skills.
Benefits
- Humana, Inc. and its affiliated subsidiaries offer competitive benefits that support whole-person well-being.
- Medical, dental and vision benefits.
- 401(k) retirement savings plan.
- Time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave).
- Short-term and long-term disability.
- Life insurance and many other opportunities.
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| 📍 | Be aware of the location restriction for this remote position: USA |
| ‼ | Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more. |
|
Salary
💸
$59,300 - $80,900 per year
|
Remote
Location
USA
|
|
Job Type
full-time
|
Posted
Mar 26, 2025
|
| 📍 | Be aware of the location restriction for this remote position: USA |
| ‼ | Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more. |
