HCC Coding Quality Specialist

CorroHealth•TX-Remote, TX

3d•Remote

About The Position

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. 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

At least 2 years of recent HCC Auditing experience.
At least 3 years of recent HCC/RA coding experience.
Certified through either the AAPC or AHIMA (Apprenticeship designations are not accepted).
Acceptable credentials: CPC, CRC, CCS, or CCS-P.
Working knowledge and experience with systems such as EMRs, Billing systems, abstraction platforms, etc.

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 codes captured are supported by documentation and properly coded.
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.
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.
Maintaining regular, predictable, and punctual attendance.