Adjustment Clerk jobs in Bellingham, WA

Title: Risk Adjustment Coding Specialist

Location: Administrative Office - Patient Accounts Department

City: Bellingham, WA

Position: Full time 40 hours, Monday-Friday 8:00am-5:00pm, non-exempt (hourly)

Compensation: The full wage scale is $24.25 - $33.95 per hour. Placement within the range is determined by an evaluation of the candidate’s background, education, and experience.

Bonus: Employees are eligible annually to participate in discretionary bonus programs, as determined by FCN, which include the Years-of-Service bonus program, the Quality Performance bonus program and Performance Recognition bonus programs.

Job Summary: Primary responsibility is to assess Risk Adjustment / HCC coding practices for Family Care Network Practitioners and billing staff ensuring that regulations are being followed

We are looking for a qualified, motivated individual who can:

• Review medical record information to identify, collect, assess, monitor, and document claims and encounter coding information as it pertains to Hierarchical Condition Categories (HCC).
• Audit provider documentation of CPT and ICD-10 codes to ensure adherence with coding and CMS Risk Adjustment guidelines.
• Evaluate HCC audit processes and provide analysis and recommendations to improve overall provider documentation and coding.
• Responsible for ongoing provider education on HCC.
• Support and participate in process and quality improvement initiatives.
• Meet productivity and quality standards.
• Review Comprehensive Health Assessment forms.
• Performs other duties, as required.

Essential Knowledge, Skills and Abilities:

• Extensive experience with healthcare coding and billing processes.
• Knowledge of Medicare managed care.
• Familiarity with EMR software.
• Extensive knowledge of CPT and ICD Codes.
• Demonstrate analytical and problem-solving ability regarding barriers to receiving and validating accurate HCC information.
• Must be able to achieve and maintain an accuracy standard of 95% or better.
• Intermediate computer skills: Word, Excel and Outlook.
• Commitment to discern and maintain confidentiality, in compliance with applicable State & Federal laws (i.e., HIPAA).
• Strong experience solving problems and addressing concerns in a collaborative manner; knowing when to request support from a supervisor.
• Ability to work both independently and as part of a team.
• Actively support and promote a positive work and team ethic.
• Proven internal and external customer service skills.
• Proven ability to prioritize and multi-task detailed projects despite frequent interruptions.
• Proven ability to understand and communicate information accurately and clearly verbally and in writing, in person and over the telephone.

About FCN: As an independent, locally owned, provider-run network of family medicine providers, we are passionate about our community's well-being. We take the time to build strong, long-term relationships with our patients and our employees. We have 11 clinics and 3 urgent care centers in Whatcom and Skagit County, in a beautiful corner of northwest Washington where the mountains meet the sea. Family Care Network offers an innovative and rewarding work environment, with a strong patient focus and a fulfilling mission.

Benefits:

Our health benefit programs are designed to take care of you and your family, offering flexibility and quality care.

• Our health benefits include: two medical plan options, a flexible dental benefit including orthodontia, vision coverage, Employee Assistance Plans, Flexible Spending Account program and Life/AD&D, Accident & Hospital insurance plans. Benefit eligibility is determined based on the full or part-time status of the position.

At FCN, we value the importance of time away from work for leisure, health and well-being. Staff members accrue a generous Paid Time Off (PTO) program for vacation and short-term healthcare needs as well as an Extended Illness Bank (EIB).

• Our PTO and EIB benefits begin accruing from the first day of employment and employees are eligible to take paid time off after 60 days of employment. An employee accrues PTO at a rate based upon the number of months of service at FCN. A new full-time employee generally accrues 18 days per year and increases over time per the Paid Time Off policy. EIB accrues based upon the number of paid hours excluding overtime, with a full-time manager accruing a maximum of 48 hours per year. Benefit eligibility is determined based on the full or part-time status of the position. Employees who are ineligible for FCN’s PTO/EIB programs accrue Paid Sick Leave per Washington State law.

Our 401k retirement plan is designed to support you in preparing for retirement planning and includes individualized financial planning guidance. Eligibility for the FCN Retirement Plan programs is determined based upon years of service and required payroll hours.

We offer the following programs:

• 401k Plan with employer match; and
• 401k Profit Sharing Plan

Required Education & Experience:

• High school diploma or equivalent
• Two or more years of medical office experience required
• Five or more years of biller/coder experience required
• Certified Medical Coder with CPC and one or more of the following required:
  • CRC
  • Minimum of two years HCC coding experience required
  • Ability to obtain CRC within 1 year

Physical Requirements: While performing the duties of this job, the employee is required to stand, walk, sit, use hand-to-finger coordination, handle or feel objects, tools or controls, reach with hands and arms, climb stairs, balance, stoop, kneel, crouch, and listen attentively. The employee must occasionally lift and/or move up to 30 pounds.

Immunization Requirements: All employees at Family Care Network (FCN) are expected to meet and maintain required immunizations as a contingency of employment. The immunization requirements are as follows: Influenza (annually), Tdap (after the age of 19), MMR, Varicella or a verified history of chickenpox disease, Two-step TST or IGRA (within the last 12 months), COVID-19 vaccine completed series and any additional immunizations determined necessary for the protection of staff and patients. Hepatitis B is also required for employees in positions with a high risk of bloodborne pathogen exposure, which includes the following: Providers, RNs, LPNs, MA-Cs, PSRs at all Urgent Care Locations, and all-laboratory staff. The Hepatitis B vaccine is strongly recommended for all other employees. FCN will cover the cost of required immunizations for any FCN employee. All employee immunizations will be administered by FCN staff except for the COVID-19 vaccine. The COVID-19 vaccine can be administered at a participating pharmacy or other healthcare location. Note: A medical or religious vaccine exemption/reasonable accommodation will be considered by submitting an FCN Exemption form for review and evaluation by the Chief Medical Officer.

Family Care Network is a Drug-Free, Equal Opportunity Employer.