HCC Quality Auditor (TEMP)

Virtix Health•Plano, TX

3d•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. JOB SUMMARY: ESSENTIAL DUTIES AND RESPONSIBILITIES: Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member. Job Description Summary 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 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

Certified through either AAPC or AHIMA (Apprenticeship designations are not accepted).
Acceptable credentials: CPC, CRC, CCS, or CCS-P.
At least 3 years of HCC coding experience.
At least 2 years of auditing experience.
Working knowledge and experience with systems such as EMRs, Billing systems, abstraction platforms, etc.
Ability to perform work at a computer terminal for 6-8 hours a day.
Ability to function in an environment with constant interruptions.
Ability to sit for prolonged periods.
Ability to lift and move material weighing up to 20 lbs (infrequently).

Nice To Haves

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, and client-specific guidelines.
Ensuring 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 PowerPoint 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.
Committing 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.
Supporting the Company’s Ethics and Compliance Program.
Complying with all internal policies and procedures.