HCC Risk Adjustment Coder, Sr.

Regal Medical Group•Los Angeles, CA

4d•$30 - $33•Hybrid

About The Position

We are looking for experienced HCC Risk Adjustment Auditors/Coders to join our team! Position Summary: The HCC Risk Adjustment/Auditor is responsible for maintaining and monitoring the Quality Assurance auditing plan for outpatient clinical data. This position works to improve the quality of coding documentation and data in the medical record and HCC database. The HCC Risk Adjustment/Auditor reports on the accuracy and consistency of the data in accordance with accepted and established standards. Risk Adjustment Auditors collaborate with the Manager to provide expertise in the use and application of coding classifications, such as ICD-9-CM and/or ICD-10-CM. Auditors also record documentation to ensure compliance in the collection of outpatient diagnoses and services. As one of the fastest-growing Independent Physician Associations in Southern California, Regal Medical Group, Lakeside Community Healthcare & Affiliated Doctors of Orange County, offers a fast-paced, exciting, welcoming, and supportive work environment. Opportunities abound, and enterprising, capable, focused people prosper with us. We promote teamwork, nurture learning, and encourage advancement for all of our employees. We want to see you excel, because we believe that your success is our success. Full-Time Position Benefits: The success of any company depends on its employees. For us, employee satisfaction is crucial not only to the well-being of our organization but also to the health and wellness of our members. As such, we are firmly dedicated to providing our employees the options and resources necessary for building security and maintaining a healthy balance between work and life. Our dedication to our staff is evident in our comprehensive benefits package. We offer a very generous mixture of benefits, including many employer-paid options.

Requirements

Must have these requirements under the umbrella of the HCC industry:
Requires knowledge in HCC Coding documentation guidelines.
Requires technical expertise in ICD-9-CM or ICD-10-CM.
Strong skills in medical record audit and review.
Regulatory requirements for coded data.
Medical record documentation requirements.
Understanding of healthcare data systems.
Proficiency in MS Outlook and Word.
Strong proficiency with Excel--must have ability to prepare spreadsheets.
Excellent written and verbal communication skills.

Nice To Haves

Certification is a plus with HCC.
AHA coding clinic is a plus.
Certification required in CPC and/or CCS, and CRC is a plus.

Responsibilities

Works as an integral member of the Finance Department.
Code review super bills and patient medical records for proper use of diagnosis and procedure codes.
Interface effectively with physicians and office staff on coding issues.
Research coding questions as needed.
Code review a wide variety of document types, i.e., Primary and specialty care medical records, mental health, substance abuse, in-patient, out-patient, non-submittals (lab), ancillary, and pharmaceutical services for HCC values.
Perform both provider office audits and online audits by reviewing patient medical records.
Provide education to the provider and staff on office audit findings.
Communicate best coding practices.
Consistently meet productivity and quality standards as outlined by the supervisor.
Generate MS Excel spreadsheets for various projects with the primary focus on tracking activities.
Make internal and external phone calls to other departments and provider offices as needed.
Learn software programs essential to the HCC department, such as iCode, EZCap, and Access Express. Also, to learn the HCC model.
Upload medical records via our internal software program iCode.
Research and correspond with our providers to obtain correct diagnosis coding as generated from internal and external error reports.
Present educational material to providers.
Perform photocopy services.
Perform scanning services.
Perform faxing services.
All other duties as directed by management.