Medical Coder

Your Future Evolves Here

Evolent Health has a bold mission to change the health of the nation by changing the way health care is delivered. Evolenteers make a difference wherever they are, whether it is at a medical center, in the office, or while working from home across 48 states. We empower you to work from where you work best, which makes juggling careers, families, and social lives so much easier. Through our recognition programs, we also highlight employees who live our values, give back to our communities each year, and are champions for bringing their whole selves to work each day. If youre looking for a place where your work can be personally and professionally rewarding, dont just join a company with a mission. Join a mission with a company behind it.

Why Were Worth the Application:

• We continue to grow year over year.
• Recognized as a leader in driving important diversity, equity, and inclusion (DE&I) efforts () .
• Achieved a 100% score two years in a row on the Human Rights Campaign's Corporate Equality Index making us a best place to work for LGBTQ+ equality.
• Named to 2020 list of the best companies for women to advance () .
• Continued to prioritize the employee experience and achieved an 87% overall engagement score on our last employee survey.
• Published an annual DE&I report () to share our progress on how were building an equitable workplace.

What Youll Be Doing:

The Coder will be on the Risk, Adjustment, STARS, Quality (RASQ) team. You will be working with our internal RASQ and market teams, clients, and providers to oversee the success of risk adjustment efforts for a large Medicaid health plan, working from home within the DC/Maryland/Virginia area.

As a key member of our market risk adjustment and quality team, you will contribute to the overall success of risk adjustment and quality activities and lead provider education efforts. You will conduct provider & office staff training related to the ICD-10-CM code set, risk adjustment, clinical documentation, and billing functions. Youll use a combination of data and chart reviews to identify patterns in provider coding, then create and deliver targeted education to improve individual coding behaviors.

Responsibilities:

• Develop relationships with providers and communicate coding and documentation guidelines to ensure correct coding, billing, and documentation
• Conduct chart reviews for providers and review provider performance
• Analyze coding and billing data to determine provider education needs
• Provide formal training to providers and staff regarding coding, billing, and documentation standards
• Assist with research, analysis, and response to compliance, coding, and inappropriate coding inquiries
• Perform the minimum number of coding quality reviews consistent with established departmental goals
• Ensure knowledge of current coding guidelines and relevant federal regulations

The Experience We Prefer:

• Associate's Degree in Health Information, Health Administration, or another relevant field
• 3-5 years of relevant coding experience
• Valid Driver License, on site clinic visits
• A high-level of coding expertise in the following areas and/or disciplines: Risk Adjustment/HCC Coding, Auditing, Outpatient coding
• Full understanding of regulatory requirements for ICD-10-CM Coding Guidelines, medical record documentation, as well as Medical Staff Rules and Regulations where applicable
• Knowledge of medical terminology, anatomy, physiology, and disease pathology
• Exceptional interpersonal skills and ability to develop successful relationships with both internal and external partners
• Strong presentation skills and ability to communicate highly technical details to non-technical audiences
• Microsoft Office skills (e.g., Word, Excel, PowerPoint)
• Strong listening skills, critical thinking, and ability to earn providers trust
• Ability to work in a highly matrixed environment
• Skills to multitask, prioritize, adapt to change, and work well under pressure
• Certified Risk Adjustment Coder (CRC) credential or similar specialty credential
• Previous training/teaching experience and customer service education experience preferred
• Creativity and knowledge of adult learning principles preferred

Technical Requirements:

Currently, Evolent employees work remotely temporarily due to COVID-19. As such, we require that all employees have the following technical capability at their home: High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations.

Evolent Health is committed to the safety and wellbeing of all its employees, partners and patients and complies with all applicable local, state, and federal law regarding COVID health and vaccination requirements. Evolent expects all employees to also comply. We currently require all employees who may voluntarily return to our Evolent offices to be vaccinated and invite all employees regardless of vaccination status to remain working from home. Certain jobs require face-to-face interaction with our providers and patients in client facilities or homes. Employees working in such roles will be required to meet our vaccine requirements without exception or exemption.

Evolent Health is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.

Compensation Range: The minimum salary for this position is $65,000, plus benefits. Salaries are determined by the skill set required for the position and commensurate with experience and may vary above and below the stated amounts.