HCC Coding Analyst I
About The Position
This Position is an entry-level role in Risk Adjustment and will learn to demonstrate general proficiency in the areas of Risk Adjustment Coding for highly regulated government insurance programs such as Medicare Advantage (MA), Medicaid, and the Affordable Care Act (ACA). This analyst will audit approved clinical documentation post-visit to ensure accurate coding practices according to general and risk adjustment coding guidelines as established by the Centers for Medicare and Medicaid (CMS) and Health and Human Services (HHS). Continued employment is dependent on the candidate obtaining CRC Certification from AAPC within 1 year of hire.
Requirements
- National Professional Coding Certification from AHIMA or AAPC
- Some work or education experience in medical coding or healthcare
- Functional knowledge or medical terminology, acronyms, anatomy, and physiology
- Demonstrated basic-level experience with Microsoft Office products
- Demonstrated excellent written and verbal communication skills
- Completion of an internal CRC training and competency evaluation no later than one year of hire
- Certified Risk Adjustment Coder (CRC) through AAPC obtained within 1 year of hire
Nice To Haves
- CRC certification already obtained
- ICD-CM diagnosis coding experience
Responsibilities
- Reviews clinical documentation to monitor coding practices and ensure accurate coding and reimbursement. Ensures review decisions are in line with Centers for Medicare and Medicaid (CMS) as well as internal department guidelines.
- Supports higher level analysts in their responsibilities and research and all internal department functions and processes, as needed.
- Maintains knowledge of coding workflow and use of available technology.
- Documents chart review results in a Risk Adjustment database for reporting purposes.
- Participates in governmental risk adjustment audits for CMS/HHS on a limited basis.
- Effectively manages workload and responsibilities.
- Develops subject matter expertise.
- Complies with HIPAA law to maintain data privacy and security.
- Completes all continuing education requirements needed for certification earned on an ongoing basis.
- Works with software programs (Microsoft Office products, coding programs, Electronic Medical Records (EMR)).
- Maintains functional knowledge of general medical terminology, medical acronyms, anatomy and physiology.
Benefits
- Generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.
- Up-front tuition coverage paid directly to the academic institution through the PEAK program.
- 100+ learning options to choose from, including undergraduate studies, high school diplomas, and professional skills and certificates, through the PEAK program.
- Eligibility to participate in the PEAK program on day 1 of employment.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed
