Ambulatory Risk Adjustment Coding Specialist

Endeavor Health•Skokie, IL

1d•$22 - $33

About The Position

Our Ambulatory Risk Adjustment Coding Specialist I plays a key role in identifying HCC codes within physician outpatient visits and ensuring they are coded accurately and to the highest specificity. They additionally will verify that documentation requirements are met to validate the HCC diagnosis code. Working closely with the ambulatory clinical documentation specialist (CDS), they will clinically verify the accuracy of HCC codes. Using compliant query guidelines, the coding specialist will query the physician should documentation need clarification or specification. The coding specialist is expected to maintain current knowledge of the ICD-10-CM codes and guidelines and meet minimum productivity requirements outlined by team leadership.

Requirements

High School Diploma required, Associates Degree preferred
CRC required within 6 months of hire
2 years experience working in healthcare or professional business environment

Responsibilities

Review/abstract HCC codes to ensure they are coded accurately, to the highest specificity possible, and make sure the required MEAT is documented, resulting in the correct CMS-HCC risk score
Identify diagnosis and chart level impairments and documentation improvement opportunities for provider education
Responsible for partnering with ambulatory clinical documentation specialists and physicians to properly code patient charts to ensure appropriate risk adjustment
Assist coding leadership by making recommendations for process improvements to further enhance coding goals and outcomes
Assists the coding team leads with onboarding new coding specialists to the role as needed.
Maintain current knowledge of ICD-10-CM codes, CMS documentation requirements, and state and federal regulations
Consistently maintain a minimum 95% accuracy on coding quality audits
Meet minimum productivity requirements as outlined by the project terms
Utilizes technical coding expertise to assign appropriate ICD-10-CM diagnosis codes, as well as assist in appropriate assignment of risk adjustment
Maintains advanced knowledge of coding all HCC diagnoses from the medical record in accordance with the ICD-10-CM coding guidelines
Assists with and completes special project work as assigned by Ambulatory Clinical Documentation Leadership