Health Risk Coding & Education Specialist II (Hybrid/Troy, MI) - Health Alliance Plan

EDUCATION/EXPERIENCE REQUIRED:

• Associate’s degree required in Health Information Management (HIM), Health Information Technology (HIT), healthcare, health service, or public health related field required.
• Bachelor’s degree or equivalent work experience in healthcare, health service or public health related field preferred.
• Two (2) years of coding experience in diagnostic and procedural coding required.
• Prior experience working with physicians/medical groups/physician offices preferred.
• Two (2) years of ICD-9-CM &ICD-10-CM coding experience/proficiency required.
• Prior healthcare related experience working with physicians/medical groups/physician offices preferred.
• Knowledge of medical billing and third party payer regulations preferred.
• Ability to get results with physicians and physician’s office staff to obtain medical records.
• Excellent communication skills and ability to work well with multiple HAP departments to get desired results.
• Knowledge of the release of health information processes and regulations.
• Knowledge of Health Insurance Portability and Accountability Act (HIPAA).
• Strong knowledge in ICD-10-CM coding and guidelines.
• Excellent quantitative, analytical, and problem solving skills.
• Excellent written and oral communication skills.
• Strong ability to work independently.
• Ability to work with automated systems.
• Ability to work across multi-disciplinary teams.
• Ability to organize and manage multiple priorities.
• Strong work ethic, reliable, resourceful, with enthusiastic attitude.
• Strong knowledge of anatomy, physiology, pathophysiology, disease processes, medical terminology, pharmacology, and coding systems.
• Knowledge in the use of Microsoft Office products.
• Knowledge of computer software programs used for data collection.
• Knowledge of Medicare Advantage risk adjustment payment methodology preferred.
• Knowledge of CMS programs, processes, and payment principles preferred.
• Knowledge of Adobe Pro preferred.

CERTIFICATIONS/LICENSURES REQUIRED:

• Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) or Certified Professional Coder (CPC) required. 
• Certified Coding Specialist (CCS), Certified Coding Specialist –Physician (CCS-P) preferred.