HCC Risk Adjustment Coder

Elite Workforce-posted about 1 year ago

$60,320 - $70,720/Yr

Full-time • Mid Level

Remote

Professional, Scientific, and Technical Services

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The HCC Risk Adjustment Coder is responsible for performing audits and training sessions related to HCC risk adjustment coding. This role involves abstracting information from medical records, documenting audit findings, and ensuring compliance with coding guidelines. The coder will also provide training to new staff and serve as a resource for team members and management.

Abstract pertinent information from assigned medical records using ICD-9-CM, CPT and/or HCPCS codes.
Provide management with input on provider performance from assigned audits and special projects.
Document detailed chart audit findings including documentation errors, medical record errors, diagnosis errors, and missed HCC opportunities in applicable audit tools on a daily basis.
Ensure audit tools contain adequate evidence to support audit findings.
Review audit tools for accuracy and completeness.
Ensure all captured diagnoses are properly documented and supported within progress notes according to CMS rules and regulations.
Report noncompliance issues detected through auditing.
Work with Medical Management to provide confidential feedback on special audits as needed.
Adhere to Official Coding Guidelines.
Research and provide courteous, accurate, and timely responses to inquiries by providers related to HCC Risk Adjustment projects and reports.
Assist with reconciliation of invalid diagnosis lists supplied by other departments.
Serve as a resource for internal and external customers to obtain information or clarification on accurate and ethical coding and documentation standards, guidelines, and regulatory requirements.
Work with health plans to ensure appropriate status information for members is reflected.
Assist with chart retrieval from provider offices based on departmental needs.

High School Diploma or Equivalent; BS/BA preferred.
2 - 5 years experience in a healthcare setting preferably related to HCC Risk Adjustment Coding and/or chart auditing.
Must possess and maintain an AAPC or AHIMA certification — CCS, CCS-P, CPC, CPC-H, CPC-P, RHIT, RHIA.

1 year experience as a High Risk Adjustment Coder (Preferred)

Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance

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