ESSENTIAL FUNCTIONS
• Lead clinical documentation improvement initiatives focused on orthopedic and musculoskeletal specialties
• Review provider documentation for completeness, specificity, medical necessity, and coding accuracy
• Partner with physicians, APPs, coding teams, and operational leaders to improve documentation workflows and reduce
revenue leakage
• Identify trends impacting reimbursement, denials, downcoding, charge lag, and documentation deficiencies
• Provide education and real-time feedback to providers regarding coding, documentation standards, payer requirements,
and compliance expectations
• Serve as a subject matter expert for Athena documentation workflows, claim edits, charge capture, and operational
reporting
• Collaborate with coding and denial management teams to resolve documentation-related reimbursement issues
• Support audit readiness and compliance initiatives through routine chart reviews and documentation monitoring
• Assist in the development and maintenance of documentation policies, workflows, tip sheets, and provider education
materials
• Analyze documentation and coding trends to support operational performance improvement and financial optimization
• Monitor payer policy changes and regulatory updates impacting MSK documentation and reimbursement
• Participate in cross-functional operational meetings and revenue cycle performance initiatives
EDUCATION
• Certified Professional Coder (CPC), CCS, RHIA, RHIT, or equivalent coding certification required
EXPERIENCE
• Minimum 5 years of clinical documentation improvement, coding, or revenue cycle experience in orthopedic/MSK specialties required
• Strong working knowledge of musculoskeletal and orthopedic procedural and diagnosis coding
Healthcare Outcomes Performance Company (HOPCo) is the leading provider of musculoskeletal value-based health outcomes management, service line management and practice management. This includes comprehensive management and optimization of specialties such as orthopedics, spine, hand, pain management, rehabilitation and neurology.
HOPCO’s integrated care and analytics platform has proven to increase the quality of patient care and program revenue while reliably reducing the total cost of care across the care continuum for practices, health systems and payors alike.
HOPCo’s affiliated payors, practices and health systems successfully participate in highly efficient value-based contracting (bundled payments, capitated population health programs, and other risk-based arrangements) utilizing HOPCo’s proprietary platforms, IT solutions, integrated analytics, and standardized care pathways. This helps our partners obtain real time, actionable insights into their systems, allowing them to comprehensively manage the entire business while improving outcomes for their treasured patients.
As a result, HOPCo has become the only organization with proven and sustainable success in population health management of musculoskeletal specialty care.
