Senior HCC Coder

Pine Park Health

Pine Park Health

Software Engineering
United States
Posted on Friday, April 28, 2023

Welcome to Pine Park Health!

About us

Pine Park Health is a value-based primary care practice that’s reshaping how residents of senior living communities experience healthcare. We provide high-quality prevention and screening, care for chronic conditions, lab work, and diagnostic testing to patients in their homes and closely partner with community staff to improve resident health and wellness. We also provide in-person and virtual Rapid Care for common concerns — like falls, wounds, or changes in behavior — to help patients avoid trips to the ER where they’re exposed to further health issues.

Over 80 communities across the Bay Area, San Diego, and Phoenix work with Pine Park today and we’re growing rapidly to expand our reach and impact. Investors include First Round Capital, Google’s AI fund, Canvas Ventures, Foundation Capital, Y Combinator, and Susa. If you’re interested in changing healthcare for seniors, join us!

The Opportunity

The Senior HCC Coder has a deep understanding of risk adjustment coding. As we build this function you are comfortable with ambiguity, special projects and being held to high performance standards. You approach mistakes as learning and are driven by curiosity to find the root of a problem. You understand that manual workflows proceed automation and are willing to perform high volume repeat tasks at industry standard accuracy. You bring professionalism to your partnerships with your direct team, executive leaders and more.

In this small team you have a range of tasks. The Senior HCC Coder extracts clinical information from a variety of medical records and assigns appropriate risk adjustment codes (ICD-10-CM) to patient records. The Senior HCC Coder assumes ownership and leads advanced and highly specialized administrative/ operational/ customer support duties that require independent initiative and judgment.

What You'll Do

  • Perform a comprehensive review of medical records and physician encounters for assessment forms
  • Correspond with Health Plan coders for the resolution of any coding discrepancies or questions
  • Evaluate each medical record to ensure M.E.A.T statements and report diagnoses are supported
  • Lead and provide work direction for one HCC Coder
  • Review all code findings (Supported, add, edit, delete) and activities submitted by the HCC Coder
  • Serve as ICD-10-CM Subject Matter Expert (SME) providing on-going ICD-10-CM education and be available to answer questions and provide guidance for providers and staff
  • Collaborate with HCC Coder to monitor provider coding patterns and conduct spot checks of documentation for providers who exhibit outlier trends that require corrective action to maintain coding accuracy
  • Develop provider education, as needed, based upon these reviews
  • Communicate effectively with providers to correct or change encounters in a timely manner
  • Maintain industry coding knowledge and required certifications

What We're Looking For

  • High school diploma or GED equivalent required
  • Extensive knowledge of ICD-10
  • Experience developing, implementing, and facilitating provider HCC education
  • Have or be working toward obtaining coding certification.
  • Familiarity with HCC coding in the Medicare market as well as commercial and Medicaid
  • A strong knowledge base of medical terminology, medical abbreviations, pharmacology, and disease processes
  • Must be able to follow instructions, meet deadlines and work independently.
  • Ability to be flexible in a work environment.
  • Effective communications skills (verbal and written)
  • Working knowledge of the business use of computer hardware and software to ensure the effectiveness and quality of the processing and security of the data.

Why You’ll Love Us

  • We’re a smart, heart-centered, low-ego group motivated to make waves in the lives of seniors and the healthcare industry.
  • We’re solving complex, vital problems that affect real people and need bright, focused, driven minds like yours to help us achieve our goals.
  • We empower team members to act like owners and have designed a learning-focused environment where you get ongoing support and regular feedback to help you grow.
  • Our hybrid work environment allows you to set your own in-office and remote schedule. We love being in an office to connect with coworkers and form meaningful relationships and make it easy for you to work from home when needed or preferred.
  • We host social events to celebrate wins, mark team member milestones and let go by having fun.

Benefits Designed for You and Yours

  • Medical, vision, and dental insurance
  • FSA and Dependent Care FSA
  • 401K retirement plan
  • 10 paid holidays
  • 15 days paid time off
  • Paid sick days
  • Paid parental leave
  • Cell phone reimbursement
  • Monthly wellness allowance
  • Professional/personal development annual allowance

Travel is required for this role. It’s required that all employees receive the COVID-19 and flu vaccines before their first day of work.

Pine Park Health is an equal opportunity employer — we aim to recruit, hire, develop, compensate, and promote regardless of race, religion, country of origin, gender, sexual orientation, age, marital status, veteran status, or disability.