2 jobs found in Victorville

Job Overview Responsible for auditing all Senior HMO members' medical records to ensure accuracy of Risk-Adjustment data and reimbursement. Maintain a professional, positive and caring attitude at all times Duties Audit PCP, specialist and hospital records for additional HCC diagnoses. Audit all assigned providers wellness visits and send a CAP based on last year chronic conditions. Log the patients Prepare provider report card following completion of each PCP review utilizing comments function of qHMO. Forward provider report card to HCC Manager. Update encounter information with additional HCC data. Conduct Risk Adjustment Data Validation (RADV) audits as requested by HCC Manager. Orient providers in the use of qHMO and documentation for Risk Adjustment. Reinforce to providers the necessity for thorough and accurate documentation and reporting of Risk Adjusted diagnoses. Contact a provider when necessary to clarify medical record documentation. Attend required...

Description Audits provider and hospital records to ensure accurate CMS-HCC coding. Reviews and codes diagnoses, maintains coding updates, prepares provider performance reports, and supports education for improved documentation. Ensures compliance with Medicare regulations and quality standards. Skills Icd-10, Cpc, Coding, Electronic health record Top Skills Details Icd-10,Cpc,Coding,Electronic health record Additional Skills & Qualifications •High school diploma or equivalent •CPC certification required •Medical coding experience preferred •Strong attention to detail and coding accuracy •Microsoft Office proficiency Experience Level Intermediate Level Pay and Benefits The pay range for this position is $22.58 - $24.33/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available...