Lead Coding & Education Specialist (Hybrid - Troy, MI) - Health Alliance Plan

EDUCATION/EXPERIENCE REQUIRED:

• Associates degree 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.
• Minimum of two (2) years of experience working in a coding lead or similar role.
• Minimum of five (5) years of coding experience and proficiency in ICD-10-CM and ICD-9-CM diagnostic and procedural coding.
• Prior experience leading teams or small groups.
• Experience with Excel spreadsheets.
• Experience working with physicians and providers’ office staff.
• Prior healthcare related experience working with physicians/medical groups/physician offices preferred.
• Knowledge of medical billing and third-party payer regulations preferred.

CERTIFICATIONS/LICENSURES REQUIRED:

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

Skills and Abilities:

• Ability to effectively lead a team.
• Ability to communicate complex coding issues and back up approach with support.
• Strong ability to work independently with limited direct supervision.
• Ability to work with automated systems.
• Ability to work across multi-disciplinary teams.
• Ability to plan, coordinate and organize multiple priorities and projects independently.
• Strong work ethic, reliable, resourceful, with enthusiastic attitude.
• Knowledge of Medicare Advantage Risk Adjustment and HHS Commercial Risk Adjustment payment methodologies preferred.
• Knowledge of CMS programs, processes, and payment principles 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 knowledge of anatomy, physiology, pathophysiology, disease processes, medical terminology, pharmacology, and coding systems.
• Strong knowledge in the use of Microsoft Office products.
• Knowledge of computer software programs used for data collection.
• Knowledge of CMS programs, processes, and payment principles preferred.
• Knowledge of Adobe Pro preferred.