HCC Coding Quality Specialist (Auditor)

CorroHealth•Plano, TX

9d•Remote

About The Position

Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. HCC Coding Quality Specialist Team Members will be responsible for reviewing the accuracy of our HCC coded records, specifically those that map to HCCs and RxHCCs. Auditors will support their findings utilizing Medicare guidelines, ICD-10-CM guidelines as well as client specific requirements. Global experience is beneficial. This is a remote position. The ideal candidate will have at least 2 years of recent HCC Auditing experience in addition to 3 years of recent HCC/RA coding experience. You will be auditing the global team of Risk Adjustment coders. All HCC/Risk Adjustment auditors MUST be certified through either the AAPC or AHIMA. (Apprenticeship designations are not accepted.) Acceptable credentials would be CPC, CRC, CCS, or CCS-P AND have at least 3 years of HCC coding experience with 2 years of auditing experience. Global experience preferred. Ensure that the codes captured are supported by the documentation within the record and are properly coded following Medicare guidelines, ICD-10-CM guidelines as well as client specific guidelines for the project. Support your findings in a way the coder can easily identify and learn from the error. Have strong and professional communication skills. Be a resource for HCC coding team members by having a deep understanding of the project and coding guidelines. Follow Risk Adjustment Data Abstraction Rules. Assist with the creation of PowerPoints presentations for training purposes. Will be required to maintain a quality score of 95% or higher. Will be required to maintain an ongoing productivity level based on project requirements. Ensure individual compliance with all privacy and security rules and regulations and commit to the protection of all Company confidential information, including but not limited to, Personal Health Information. Align conduct with AHIMA's Standards of Ethical Coding and the Company’s Code of Ethics and Business Conduct and support the Company’s Ethics and Compliance Program. Comply with all internal policies and procedures. Regular, predictable, and punctual attendance is required.

Requirements

All auditors MUST be certified through either the AAPC or AHIMA. (Apprenticeship designations are not accepted.)
Acceptable credentials would be CPC, CRC, CCS, or CCS-P.
Must have at least 3 years of HCC coding experience with 2 years of auditing experience.
Must have working knowledge and experience with systems such as EMRs, Billing systems, abstraction platforms, etc.
HIPAA compliant home office
High-speed secure internet connection

Nice To Haves

Global experience is beneficial.
Global experience preferred.

Responsibilities

Reviewing the accuracy of HCC coded records, specifically those that map to HCCs and RxHCCs.
Supporting findings utilizing Medicare guidelines, ICD-10-CM guidelines as well as client specific requirements.
Ensuring that the codes captured are supported by the documentation within the record and are properly coded following Medicare guidelines, ICD-10-CM guidelines as well as client specific guidelines for the project.
Supporting findings in a way the coder can easily identify and learn from the error.
Being a resource for HCC coding team members by having a deep understanding of the project and coding guidelines.
Following Risk Adjustment Data Abstraction Rules.
Assisting with the creation of PowerPoints presentations for training purposes.
Maintaining a quality score of 95% or higher.
Maintaining an ongoing productivity level based on project requirements.
Ensuring individual compliance with all privacy and security rules and regulations and commit to the protection of all Company confidential information, including but not limited to, Personal Health Information.
Aligning conduct with AHIMA's Standards of Ethical Coding and the Company’s Code of Ethics and Business Conduct and supporting the Company’s Ethics and Compliance Program.
Complying with all internal policies and procedures.
Regular, predictable, and punctual attendance is required.