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Baylor Scott & White Health Risk Adjustment Auditor II- Temple, TX in Temple, Texas

The Risk Adjustment Auditor-Educator Level II for Baylor Scott and White Health (BSWH) is responsible for supporting the instruction of risk adjustment coders on HCCs and Auditing, as directed by management. They are responsible for understanding and communicating all aspects of Risk Adjustment. The Risk Adjustment Auditor-Educator Level II will also be responsible for supporting management, with direction, in provider audits and may be asked to create / present training and education to Providers on Risk Adjustment.

In addition, the Risk Adjustment Auditor II for BSWH has the following responsibilities:

  • Interpret health record documentation to code and abstract diagnoses and/or procedures for inpatient, outpatient, and clinic cases

  • Mentor and lead Risk Adjustment Auditor I’s, including the review of scorecards

  • Support coder instruction in HCC’s and Risk Adjustment auditing

  • Create educational material and present training to providers, as needed

  • Maintain HCC coder productivity metrics

  • Directly communicates with multiple levels of organization, including peer staff, management, and providers

  • Conduct focused HCC reviews on providers and clinics, as directed by management, tracking results and identifying trends and deficiencies for follow-up training of Risk adjustment coders and/or Providers

  • Independently, or as directed, research complex coding HCC issues and keep abreast of coding and compliance changes as communicated by CMS, HHS, AHA, AMA, and the Federal Register pertaining to Risk Adjustment; share knowledge with co-workers.

  • Review of coder work on Provider audits

  • Protect data integrity and validity.

  • Maintain and respect patient confidentiality for accessing and disclosure of health information.

The ideal candidate will possess the following knowledge, skills and abilities:

  • Knowledge of ICD-10-CM and CPT coding conventions, and clinical documentation.

  • Knowledge of anatomy, physiology, pathological processes of disease, and medical terminology

  • Knowledge of and compliance with standards of ethical coding as set forth by the American Health Information Management Association (AHIMA) and the American Academy of Professional Coders (AAPC)

  • Prior Risk Adjustment Coding experience preferred

  • Experience providing physician feedback preferred. Group training experience preferred.

  • Critical thinking skills regarding chart abstraction and coding.

  • Efficient Time management

  • Competence in use of Microsoft applications such as Word, Excel, and PowerPoint strongly preferred

  • Location/Facility – Baylor Scott & White Health

  • For more information on the facility, please click our Locations link.

  • Specialty/Department/Practice – Document Accuracy CTX

  • Shift/Schedule – Full-Time, Days

  • Benefits – Our competitive benefits package includes*:

    • Immediate eligibility for health and welfare benefits
  • 401(k) savings plan with dollar-for-dollar match up to 5%

  • Tuition Reimbursement

  • PTO accrual beginning Day 1

*Note: Benefits may vary based upon position type and/or level.

Baylor Scott & White Health (BSWH) is the largest not-for-profit health care system in Texas and one of the largest in the United States. With a commitment to and a track record of innovation, collaboration, integrity and compassion for the patient, BSWH stands to be one of the nation’s exemplary health care organizations. Our mission is to serve all people by providing personalized health and wellness through exemplary care, education and research as a Christian ministry of healing. Joining our team is not just accepting a job, it’s accepting a calling!

Bachelor’s Degree or Equivalent Experience

2+ years of experience

CPC, COC, CCS, CCS-P, CIC, CFPC, CEMC, CRC, RHIT, or RHIA Certification Required

As a health care system committed to improving the health of those we serve, we are asking our employees to model the same behaviors that we promote to our patients. As of January 1, 2012, Baylor Scott & White Health no longer hires individuals who use nicotine products.

We are an equal opportunity employer committed to ensuring a diverse workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.