MRA Coding Specialist

People. Passion. Purpose. 

At P3 Health Partners, our promise is to guide our communities to better health, unburden clinicians, align incentives and engage patients. We are a physician-led organization relentless in our mission to overcome all obstacles by positively disrupting the business of health care, transforming it from sickness care into wellness guidance. If you are passionate about your work; eager to have fun; and motivated to be part of a fast-growing organization, then you should consider joining our team. 

Overall Purpose

The MRA Coding Specialist reviews retrospective medical record documentation and supports the providers by ensuring documentation supports the submission of relevant ICD-10-CM code information in accordance with national ICD-10-CM and MRA coding guidelines, as well as internal policies, guidelines and appropriate reimbursement requirements.  This person will ensure member encounter data (disease conditions) is being accurately documented and relevant ICD-10-CM diagnosis codes are captured.  The outcome will be accurate and complete capture of all MRA HCC diagnosis codes that support the documented clinical severity and complexity of the member for each encounter reviewed.  

Essential Functions 

• Medical records (notes/charts) will be assigned to review and code electronically  
• Abstract and code ICD-10-CM MRA HCC diagnosis based on clinician documentation and sending queries when necessary  
• Perform ongoing analysis of medical records for appropriate coding compliance  
• Research and resolution of coding projects as assigned  
• Responsible for daily production goal and quality goal of 95% accuracy  
• Attend conference calls as necessary to provide information and/or feedback  
• Other duties as assigned by supervisor/manager 

 Knowledge, Skills, and Abilities

• Knowledge of MRA HCC coding guidelines and methodologies including; ICD-10-CM, CMS, AHA Coding Clinic and HHS  
• Advanced proficiency with Microsoft Office  
• Extensive knowledge in medical terminology and ability to research coding related questions 
• Ability to work independently and collaboratively in a fast-paced team environment  
• Excellent verbal, written and interpersonal communication skills  
• Dependable, highly motivated team player with a great attitude  
• Possess strong organizational skills and attention to detail, technically savvy, self-motivated, with the ability to troubleshoot and problem solve  
• As part of the screening process, all coders must take and pass a coding test (with 90% accuracy)  

Experience

• 3 years of coding and audit experience and understanding of Medicare Risk Adjustment compliance rules and regulations 

Education 

• High school diploma or equivalent required.  
• Certified through AAPC or AHIMA (CPC, CCS, RHIT), CRC preferred or willingness to obtain