Coding & Education Specialist

  • Long Beach, CA
  • Full-time

Company Description

About Mackenzie Search:

Great talent is both rare and valued....... the ability to recognize great talent is even more rare!

 

One premise remains constant, even with the technological advances over the past half-century:

It takes Tier-1 Leadership & Talent to build Strong, Successful Organizations! That's where Mackenzie comes in.

Mackenzie was founded in 1992 to grow strong LifeScience, Animal Science, HealthCare and Technology companies with their most important asset - Talent, and to become the preeminent consulting firm in our space. Those goals have been accomplished time and time again as Mackenzie has been recognized simultaneously and in consecutive years (Business Journal Book of lists) as the Mid-Atlantics top firm, with offices nationwide. Along the way we have completed thousands of searches from the Boardroom to the C-Suite, and from the Sales Field to the Scientific Bench on both the Business and Manufacturing sides of an organization. Mackenzie has expanded Start-ups and Conglomerates locally, regionally, and nationally and filled just about every position in the organizational matrix.

Job Description

Job Summary

The Coding and Education Specialist will be responsible for performing ongoing chart reviews in compliance with the guidelines provided by CMS for risk adjustment.

Essential Functions• Maintains application of latest guidance on criteria applicable to calendar year being reviewed • Applies appropriate coding standards for charts being reviewed • Implements training and coaching plans with providers and Health Plan staff (QI and Provider Services) • Assists in development of training and coaching materials • Escalates clinical questions to appropriate superior (Dir or VP) • Escalates possible fraud to compliance and VP

Knowledge/Skills/Abilities

• Ability to manage quality work and to enforce quality healthcare throughout the organization (developing). • Ability to identify barriers to quality healthcare and/or gaps in process that interfere with delivery of quality healthcare (entry level). • Ability to demonstrate strength in strategic and analytical thinking, problem solving, and presentation skills (developing). • Ability to demonstrate strength in teaming and interpersonal skills, and the ability to initiate and maintain cross-team relationships (developing). • Ability to meet mission-critical deadlines and to motivate staff to meet these deadlines; proven ability to manage personal stress and those of staff through proactive management and emotional intelligence skills (entry level). • Ability to manage projects, including the ability to manage people and time resources and the ability to monitor the effectiveness of activities (entry level). • Ability to demonstrate solid organizational skills (developing). • Ability to demonstrate mastery of multiple healthcare knowledge areas, including clinical, coding, business operations, and IT analytics (entry level). • Ability to maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA) (developing).

    Qualifications

    Required Education: Associates degree or equivalent work experience

    Required Experience: • Minimum of 2 years experience in health care coding • Minimum of 2 years experience in Reporting and Analytics • Must have fluency and proficiency with CMS Risk Adjustment Methodology • Must have 2 years of experience in coding/medical record chart review for risk adjustment and have a background with risk adjustment data validations.

    Required Licensure/Certification/Associations: • Coding certification • Active CCS, CCS-P or CPC credential

    Preferred Education: Preferred field: Healthcare management, coding

    Preferred Experience: • HEDIS reporting or collection experience • State QI experience • Star Ratings experience

    Preferred Licensure/Certification/Associations: Microsoft certification(s)

    Additional Information

    Compensation

    • Base Salary - Salary: $70,000 DOE
    • Full Benefits
    •