Coding and Documentation Specialist - Hierarchical ...

At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence. Summary of Primary Function/General Purpose of Position The HCC Coding & Documentation Specialist provides subject matter expertise and oversight of documentation and review to support Bon Secours Mercy Healthu2019s Risk Score Accuracy (RSA) initiative and the Hierarchical Condition Categories (HCC) coding program. This role coordinates prospective, concurrent and retrospective chart reviews for diagnosis coding accuracy and compliant supportive documentation and communicates provider coding accuracy concerns and challenges to appropriate leaders throughout the Ministry. This role is vital in providing direct oversight and subject matter expertise of Population Health RSA programs to ensure value-based contract success. This is a remote/work from home position. Hire must be open to working eastern time zone hours. Essential Job Functions + Reviews ambulatory encounters in the electronic medical record for accuracy and appropriateness of provider documentation and ICD-10-CM diagnosis coding, to ensure compliance with state and federal guidelines. + Tracks, compiles and escalates examples of trends related to documentation challenges involving electronic health record/software/information technology processes. + Works with HCC Coding Supervisor to communicate provider coding accuracy concerns and challenges to System and Local Market leadership. + Identifies opportunities for performance improvement related to system-wide RSA and HCC and other risk adjustment coding initiatives. Works with HCC Coding Supervisor and System Director of RSA to develop, implement and monitor procedures that support organizational goals and business objectives related to the RSA and HCC program. + Participates as needed in collaborative coding education forums with other teams throughout the Ministry. + Maintains knowledge of current professional coding certification requirements and promotes recruitment and retention of certified staff in coding positions within the health system. This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job related duties as required by their supervisor, subject to reasonable accommodation. Licensing/Certification Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) (required) Certified Risk Coder (CRC) or equivalent (preferred) Education Bacheloru2019s Degree (preferred) Work Experience 5 years of ICD-10-CM coding experience, within a physician office, health system or payer (preferred) Working Conditions Periods of high stress and fluctuating workloads may occur. Long-distance or air travel as needed- not to exceed 10% travel. Ability to travel to all BSMH markets. General office environment. Skills Current Procedural Terminology (CPT) HCPCS ICD-10 RSA Risk Score Accuracy Electronic medical records Medical Coding Performance Improvements Collaboration Cross Functional Collaboration Teamwork Attention to Detail Critical Thinking Accuracy Healthcare Software Coding conventions CMS OIG Risk adjustment coding Many of our opportunities reward your hard work with: Comprehensive, affordable medical, dental and vision plans Prescription drug coverage Flexible spending accounts Life insurance w/AD&D Employer contributions to retirement savings plan when eligible Paid time off Educational Assistance And much more Benefits offerings vary according to employment status All applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you'd like to view a copy of the affirmative action plan or policy statement for Mercy Health u2013 Youngstown, Ohio or Bon Secours u2013 Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employers, please email . If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at

Created: 2025-10-06