Hcc Risk Adjustment Coding Jobs in Missouri (NOW HIRING)

Job Type
Full-time
Description
HIM Coding and Documentation Educator - Health Information Management - Full Time
Ste. Genevieve County Memorial Hospital is a Critical Access Hospital, stand-alone, not-for-profit hospital located in Ste. Genevieve, MO, which focuses on personalized care. Our 25-inpatient bed facility is a Medicare 4-star rated and is ranked in the top 1% nationally for Patient Safety, Quality, and Efficiency. SGCMH has also been recognized by Becker's 150 Top Places to Work in Healthcare. We are proud to extend the mission of SGCMH by putting people first with excellent, personalized, and compassionate healthcare. Our deep community roots date back as the oldest town west of the Mississippi river and is the first French settlement Missouri with the hospital employing approximately 490 employees and 100 multi-specialty providers on staff. We have all the best qualities of working in a large hospital without all the hassle of driving to the city and working in a corporate environment.
Benefits are one of the ways we encourage health for you and your family. Our generous package includes medical, dental and vision coverage. But health is more than a well-working body: It encompasses body, mind and social well-being. To that end, we've launched a Wellness Program to address your holistic health. Our Wellness Program includes financial incentives, counseling, sick, and paid time off. We also offer retirement planning.
What to expect as a Coding and Documentation Educator:
• Perform prospective and retrospective audits of inpatient, outpatient, and clinic encounter documentation and coding.
• Validate ICD-10-CM, ICD-10-PCS, CPT, and HCPCS Level II codes for accuracy and compliance.
• Review and educate providers on documentation to ensure medical necessity that supports provider and coder level of service billed, and alignment with coding and billing standards including HCC's (e.g., CMS, OIG, MAC guidelines).
• Identify patterns of risk, under-coding, over-coding, and potential compliance issues; prepare detailed audit findings and recommendations.
• Collaborate with providers and coders to deliver targeted feedback, education, and training based on audit results.
• Develop and implement corrective action plans in coordination with HIM leadership when deficiencies are identified.
• Monitor regulatory updates and changes to coding guidelines, reimbursement policies, and documentation requirements.
• Assist in preparing for external audits by payers or regulatory bodies, including documentation submission and response coordination.
• Maintain audit logs, metrics, and reporting dashboards to track performance, trends, and areas of risk.
• Support the ongoing development and implementation of internal auditing policies and procedures.
Requirements
Qualifications:
• Licensure required: CPC, CCS
• Minimum of 5 years ICD-10-CM, ICD-10-PCS, CPT 4 multi-specialty coding experience with an extensive knowledge of E/M leveling based on medical decision making.
• Strong knowledge of CMS physician and ancillary documentation regulations, E/M, ICD-10-CM, AMA/CPT coding guidelines, and resources.
• Familiarity with coding compliance tools, Meditech EMR system, and encoder software.
• Demonstrated ability to interpret medical record content and communicate complex concepts to clinical and non-clinical stakeholders.
• High attention to detail, strong analytical skills and ability to work independently.
Preferred Qualifications:
• Licensure preferred: RHIT or RHIA
• Bachelor's Degree referred
• Prior experience in a Critical Access Hospital or rural health clinic (RHC) setting.
• Certified Professional Medical Auditor (CPMA) or equivalent credential.
• Knowledge of rural health billing, including UB-04 and CMS-150 claim from nuances.
Your next move.
Now that you know more about being a HIM Coding and Documentation Educator on our team, we hope you'll join us. At SGCMH you'll reaffirm every day how much you love this work, and why you were called to it in the first place.
SGCMH is an equal opportunity employer. All recruiting, training, and employment decisions are made in accordance with applicable federal, state, and local laws and without regard to race, color, ancestry, national original gender, pregnancy, gender identity, sexual orientation, religion, age, disability, handicap, military or veteran status or any other legally protected status.