Risk Adjustment Coder Professional Billing II, FT, Days,

Prisma Health • Greenville, SC

10h • Onsite

About The Position

Conducts prospective review to abstract Hierarchical Condition Categories (HCC's) codes to report for the calendar year. Communicates (via Epic and in person) with providers on any outstanding HCC capture opportunities. Conducts retrospective reviews to ensure that documentation supports reporting the Hierarchical Condition Category code prior to payor submission.

Requirements

• High School diploma or equivalent or post-high school diploma / highest degree earned.
• Five (5) years professional fee coding experience
• Certified Professional Coder (CPC), and Certified Risk Adjustment Coder (CRC)
• Knowledge of office equipment (fax/copier)
• Proficient computer skills including word processing, spreadsheets, database
• Data entry skills
• Mathematical skills

Nice To Haves

• Associate degree preferred

Responsibilities

• Conducts prospective review of charts to identify HCC opportunity.
• Conducts retrospective review of charts to confirm documentation supports reporting.
• Utilizes payor specific software to assist in capturing HCCs.
• Communicates with providers about HCC opportunities for improvement.
• Identifies suspect conditions that would potentially support reporting an HCC.
• Participates in education offerings
• Participates in monthly meetings
• Performs other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED