MMG coder III

Methodist Health System•Dallas, TX

About The Position

Your Job: The Risk Adjustment Coder works in a collaborative effort directly with physicians and their office STAFFnd other support departments to review medical records and other clinical documentation to identify appropriate risk adjustment codes and quality gap closure opportunities. The major focus of the position is to collect and review documents to support the organization’s quality and risk adjustment initiatives, which results in improving quality of care.

Requirements

High School Diploma or GED required.
Two (2) + years’ experience in a primary care environment is required.
Coding Certificate required. AAPC or AHIMA coding certified preferred.
CRC (certified risk coder) is required, or minimum of 3-5 years’ experience in risk adjusting coding in lieu of certificate.
Strong knowledge of Microsoft Office Suite (Excel-basic mathematical formulas, charts, tables).
Strong medical coding and third party operating procedures and practices.
Knowledge of CPT/ICD-9 & 10 & Medical Terminology.

Responsibilities

Ensures compliance with all applicable Federal, State and/or County laws and regulations related to coding and documentation guidelines for Risk Adjustment.
Reviews for clinical indicators and query providers to capture the severity of illness of the patient.
Reviews of medical records, patient medical history and physical exams, physician orders, progress notes, consultation reports, diagnostic reports, operative and pathology reports, and discharge summaries to verify whether the diagnosis codes are supported by the documentation and ensure with ICD-10-CM guidelines for coding and reporting and the diagnosis codes for each chronic or major medical condition have been captured correctly.
Provides feedback to internal clients on examples of documentation and physician self-coding that do not meet quality standards, examples of missed operations missed opportunities and Identifies clinical coding and documentation trends and training needs to improve the quality of documentation to reflect our patients’ health data.
Demonstrated ability to utilize a variety of electronic medical records systems.
Ability to manage significant work load, and to work efficiently under pressure meeting established deadlines with minimal supervision.
Other duties as assigned and modified at manager’s discretion.