Title: Risk Adjustment Coder Location: BAKERSFIELD, California, United States Department: Risk Management Job Description: The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric, full-service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Health’s Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, health plans and employers with a business objective to excel in coordinating patient care in a manner that supports containing costs while continually improving quality of care and levels of service. Dignity Health MSO accomplishes this by capitalizing on industry-leading technology and integrated administrative systems powered by local human resources that put patient care first. Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art, flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options, including medical, dental and vision plans, for the employee and their dependents, Health Spending Account (HSA), Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave. As a Coder, you will ensure precise communication with insurance companies so that services are documented correctly and payments are processed efficiently. Every day you will accurately translate patients’ medical records into standardized codes for diagnoses and treatments. Using your expertise and training, you will ensure compliance with legal, regulatory, and organizational standards. To be successful in this role, you must combine accuracy and attention to detail with a strong knowledge of coding standards and healthcare regulations. Clear communication with providers and staff, along with efficient management of records, ensures claims are processed correctly and on time. - Review patient medical record information via population health tools on both a retroactive and prospective basis to identify, assess, monitor and review network coding opportunities as it pertains to risk adjustment. - Ensure that the diagnosis codes for each chronic or major medical condition have been captured and work to educate providers on opportunities to improve documentation on medical conditions. - Review clinical documentation across the network to identify patterns and trends in clinical documentation. Work with network providers to improve clinical documentation to better support CMS Risk Adjustment guidelines. - Develop education materials and tools to help network providers improve clinical documentation and support Hierarchical Condition Category (HCC) coding capture. - Participate network performance improvement initiatives. - Safeguards medical records and preserves the confidentiality of personal health information through the observance of physician network policies pertinent to the release of medical record information, record retention, and HIPAA privacy and security. ***This position is remote. Job Requirements Minimum Qualifications: - Associates degree or equivalent work experience - CPC, CRC, CCS, CCS-P, or RHIT - Advanced knowledge of CPT and ICD-10 coding - Knowledge of federal and state guidelines on all coding systems and sponsored programs. - Familiarity and understanding of CMS HCC Risk Adjustment coding and data validation requirements. - Must possess the ability to work independently with strong organizational, communication and interpersonal skills to support the management of multiple priorities, at multiple practice locations, with significant attention to detail for completion of both verbal and written external communications. - Computer literacy of medical information system, records management software, encoders. - Must have excellent verbal communication skills. - Proficiency in MS office (Outlook, Excel, Word). Preferred Qualifications: - 2-3 years of experience in risk adjustment/HCC coding strongly preferred

Ensure accurate coding of medical records, maintain compliance with healthcare regulations, and communicate effectively with staff to facilitate timely claims processing and resolve discrepancies in billing accounts.

Where You’ll Work Virginia Mason Franciscan Health has a rich history of providing exceptional healthcare, dating back to 1891. Building upon a legacy of compassionate care and innovation, our organization has evolved over the years through strategic partnerships and integrations to expand our reach and services across the Puget Sound area.Today, as Virginia Mason Franciscan Health, we remain deeply committed to healing the whole person – body, mind, and spirit – in the communities we serve. This commitment is strengthened by the diverse expertise and shared values brought together through our growth.Our dedicated providers offer a full spectrum of health care services, from routine wellness to complex disease management, all grounded in rigorous research and education. Our comprehensive network of 10 hospitals and nearly 300 care sites strategically located across the greater Puget Sound region reflects our ongoing commitment to accessibility and comprehensive care.We are proud of our pioneering medical advances and numerous awards and accreditations that reflect our dedication to excellence. When you join Virginia Mason Franciscan Health, you become part of a team that delivers top-quality, professional healthcare in modern, well-equipped facilities, and contributes to a legacy of service built on collaboration and shared purpose. Job Summary and Responsibilities As a Coder, you will ensure precise communication with insurance companies so that services are documented correctly and payments are processed efficiently. Every day you will accurately translate patients’ medical records into standardized codes for diagnoses and treatments. Using your expertise and training, you will ensure compliance with legal, regulatory, and organizational standards. To be successful in this role, you must combine accuracy and attention to detail with a strong knowledge of coding standards and healthcare regulations. Clear communication with providers and staff, along with efficient management of records, ensures claims are processed correctly and on time. - Abstracts, assigns and sequences ICD-10-CM/CPT/HCPCS codes to diagnoses and procedures as supported by documentation. Assures the final diagnoses and operative procedures as stated by the physician are valid and coded to the highest level of specificity. Abstracts all necessary information from documentation to identify secondary complications and co-morbid conditions. - Meets FMG Production standards for coding procedures. - Meets FMG Quality standards per the Coding Audit and Monitoring process. - Follows all Coding department policies and procedures. - Understands and applies changes in the external regulatory environment, third party reimbursement agencies, and stays current with coding updates ensuring clean claims are submitted for adjudication. - Performs a comprehensive review of the documentation to assure the presence of all component parts such as: patient and record identification, signatures and dates where required and other necessary data. Job Requirements Education/ Work Experience: Two years of coding experience using CPT and ICD-10-CM or equivalency. ***Surgery coding experience strongly preferred. Licensure/Certifications: Certified Professional Coder Apprentice (CPC-A), (CPC) (AAPC) or Certified Coding Associate (CCA), (CCS, CCS-P) (AHIMA) required.

Where You’ll Work Virginia Mason Franciscan Health has a rich history of providing exceptional healthcare, dating back to 1891. Building upon a legacy of compassionate care and innovation, our organization has evolved over the years through strategic partnerships and integrations to expand our reach and services across the Puget Sound area.Today, as Virginia Mason Franciscan Health, we remain deeply committed to healing the whole person – body, mind, and spirit – in the communities we serve. This commitment is strengthened by the diverse expertise and shared values brought together through our growth.Our dedicated providers offer a full spectrum of health care services, from routine wellness to complex disease management, all grounded in rigorous research and education. Our comprehensive network of 10 hospitals and nearly 300 care sites strategically located across the greater Puget Sound region reflects our ongoing commitment to accessibility and comprehensive care.We are proud of our pioneering medical advances and numerous awards and accreditations that reflect our dedication to excellence. When you join Virginia Mason Franciscan Health, you become part of a team that delivers top-quality, professional healthcare in modern, well-equipped facilities, and contributes to a legacy of service built on collaboration and shared purpose. Job Summary and Responsibilities As a Coder, you will ensure precise communication with insurance companies so that services are documented correctly and payments are processed efficiently. Every day you will accurately translate patients’ medical records into standardized codes for diagnoses and treatments. Using your expertise and training, you will ensure compliance with legal, regulatory, and organizational standards. To be successful in this role, you must combine accuracy and attention to detail with a strong knowledge of coding standards and healthcare regulations. Clear communication with providers and staff, along with efficient management of records, ensures claims are processed correctly and on time. - Abstracts, assigns and sequences ICD-10-CM/CPT/HCPCS codes to diagnoses and procedures as supported by documentation. Assures the final diagnoses and operative procedures as stated by the physician are valid and coded to the highest level of specificity. Abstracts all necessary information from documentation to identify secondary complications and co-morbid conditions. - Meets FMG Production standards for coding procedures. - Meets FMG Quality standards per the Coding Audit and Monitoring process. - Follows all Coding department policies and procedures. - Understands and applies changes in the external regulatory environment, third party reimbursement agencies, and stays current with coding updates ensuring clean claims are submitted for adjudication. - Performs a comprehensive review of the documentation to assure the presence of all component parts such as: patient and record identification, signatures and dates where required and other necessary data. Job Requirements Education/ Work Experience: Two years of coding experience using CPT and ICD-10-CM or equivalency. ***Surgery coding experience strongly preferred. Licensure/Certifications: Certified Professional Coder Apprentice (CPC-A), (CPC) (AAPC) or Certified Coding Associate (CCA), (CCS, CCS-P) (AHIMA) required.