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Coding Specialist

Coding Specialist

at Signify Health


How will this role have an impact?

Under the supervision of the Manager of Coding, this position is responsible for ICD-10 coding of Health Risk Evaluations of Medicare and Medicaid members that are performed by the Signify Health physicians and reviewing the Health Risk Assessments/Evaluations to insure completeness, accuracy and compliance with CMS guidelines.

What will you do?

  • Reviews health risk assessments/evaluations to determine completion and compliance with CMS guidelines on a timely basis.
  • Reviews and assesses the accuracy, completeness, specificity and appropriateness of diagnosis codes identified in the health risk assessments/evaluations.
  • Reviews health risk assessments/evaluations to accurately and completely assign all ICD-9/10 codes that are clinically identified and supported in the assessment/evaluation on a timely basis.
  • Communicates timely and effectively with supervisor regarding issues with the health risk assessments/evaluations and/or corrections required to the health risk assessments/evaluations.
  • Understanding the relationship between IC-9/10 coding and HCC (hierarchical condition category) coding.
  • Utilizes advanced, specialized knowledge of medical codes and coding protocol by providing guidance to the Director of Coding to ensure the organization is following Medicare coding protocol for payment of claims.
  • Demonstrate a commitment to integrating coding compliance standard into coding practices. Identify, correct and report coding problems.
  • Maintain adequate knowledge of compliant coding procedures related top Medicare Risk Adjustment.
  • Maintain coding credentials
  • Complete special projects as assigned by management, which require defining problems, and implementing required changes.
  • Follows all legal and policy requirements for HIPAA protected data.
  • Actively demonstrates teamwork at all times.
  • Ability to work overtime.
  • Is able to meet and maintain required accuracy and efficiency standards.

We are looking for someone with:

  • Must hold an active CPC, CPC-A, COC, CCS, CCS-P or CCA
  • Current coding certification in good standing.
  • CRC required
  • ICD-10 Coding Certification will be required
  • Minimum of 1 year of experience of ICD-10 coding.
  • Prior work experience in the healthcare field specifically related to coding is preferred.
  • Experience and knowledge of Medicare HCC coding.
  • Experience with medical record documentation.
  • Prior medical chart auditing/quality experience preferred.
  • Advanced knowledge of medical terminology, abbreviations, anatomy and physiology, major disease processes, and pharmacology

About Us:

Signify Health is helping build the healthcare system we all want to experience by transforming the home into the healthcare hub. We coordinate care holistically across individuals’ clinical, social, and behavioral needs so they can enjoy more healthy days at home. By building strong connections to primary care providers and community resources, we’re able to close critical care and social gaps, as well as manage risk for individuals who need help the most. This leads to better outcomes and a better experience for everyone involved.

Our high-performance networks are powered by more than 9,000 mobile doctors and nurses covering every county in the U.S., 3,500 healthcare providers and facilities in value-based arrangements, and hundreds of community-based organizations. Signify’s intelligent technology and decision-support services enable these resources to radically simplify care coordination for more than 1.5 million individuals each year while helping payers and providers more effectively implement value-based care programs.

We are committed to equal employment opportunities for employees and job applicants in compliance with applicable law and to an environment where employees are valued for their differences.

Diversity and Inclusion are core values at Signify Health, and fostering a workplace culture reflective of that is critical to our continued success as an organization.