HCC Code Reviewer

Confluence Health

13h•$25 - $40•Remote

About The Position

Located in the heart of Washington, we enjoy open skies, snow-capped mountains, and the lakes and rivers of the high desert. We are the proud home of orchards, farms, and small communities. Confluence Health actively supports the communities we serve and their quality of life through our community support program and through our individual efforts as involved community members. Full Time Employees of Confluence Health receive a wide range of benefits in addition to compensation. Medical, Dental & Vision Insurance Flexible Spending Accounts & Health Saving Accounts Paid Time Off Generous Retirement Plans Life Insurance Long-Term Disability Gym Membership Discount Tuition Reimbursement Employee Assistance Program Adoption Assistance Shift Differential For more information on our Benefits & Perks, click here! Summary Certified Coders have the option to work virtually. Must reside in the state of WA, OR, ID, WI, FL, MT, GA, TX, AZ, TN. The HCC Code Reviewer is responsible for maintaining and monitoring the quality of coding through established auditing and education practices. This role will review, identify, research and code all Risk Adjustment and Hierarchical Condition Category (HCC) encounters to ensure accuracy, specificity, appropriateness, and documentation standards are met. The HCC Code Reviewer will coordinate and collaborate with operational leadership to implement best practices and monitor compliance of established CMS HCC Risk Adjustment coding guidelines. Position Reports To: Coding Department Manager

Requirements

High school diploma or equivalent GED
One of the following primary coding certifications: CPC, CIC, COC from American Academy of Professional Coders (AAPC) or CCA, CCS, CCS-P, RHIA, RHIT from American Health Information Management Association (AHIMA).
Second coding certification in Risk Adjustment Coding (CRC) from AAPC or ability to obtain CRC within six months of hire.
Minimum 2-years coding experience.
Comprehensive knowledge of ICD-10, CPT and HCPCS coding
Proficiency using Microsoft Office products guidelines.

Nice To Haves

Associate degree in business or related clinical field
Experience with EPIC EHR.
Experience using distance learning/meeting programs
Strong qualitative and analytical skills
Excellent communication skills

Responsibilities

Review medical records to verify and ensure completeness, accuracy and compliance with applicable CMS HCC Risk Adjustment coding guidelines and regulations for services rendered.
Ability to assign appropriate ICD-10 diagnosis codes.
Serve as the HCC Risk Adjustment coding resource for diagnostic coding issues.
Stay up to date with coding guidelines, rules, and regulations related to Risk Adjustment and HCC coding.
Maintain department coding production standards.
Ensure compliance with all applicable Federal and/or State laws and regulations related to coding and documentation guidelines for Risk Adjustment encounters.
Assist with coding audits to validate medical record documentation and coding accurately reflects coding based on CMS Hierarchical Condition Categories (HCC) as applicable to Medicare Risk Adjustment reimbursement initiatives.
Collaborate with leadership to refine the HCC Risk Adjustment program through establishing education and feedback pathways and compliance strategies.
Communicate professionally and effectively with providers and coders, educating them to ensure that correct HCC diagnosis codes are chosen based on documentation
Performs other tasks as requested by Supervisor, Manager or Director.
Demonstrate Standards of Behavior and adhere to the Code of Conduct in all aspects of job performance at all times.