ICONMA

Professional Coder I Location: Remote (NY PA NJ DE CT) Duration: 6 months Description: This position is accountable for accurately reviewing, interpreting, auditing, coding and analyzing medical record documentation for diagnosis accuracy, correct documentation, and Hierarchical Coding Condition (HCC) abstraction. Review may include inpatient, outpatient treatment and/or professional medical services, according to ICD-9/ICD-10 CM coding guidelines and risk adjustment model regulations. This position supports Annual Commercial (ACA) and Medicare Advantage Risk Adjustment Data Validation Audits (RADV) along with the annual Risk Adjustment life cycle for the Medicare, Medicaid, and Commercial lines of business. Responsibilities: - Can understand and translate CPT, HCPC, ICD-9/ICD-10 codes for HCC abstraction. - Review medical records for completeness, accuracy and compliance with applicable coding guidelines and regulations. - Identify, compile and code member/patient data,...

The Coder reviews clinical documentation and diagnostic results and applies appropriate ICD-10-CM.  Codes are used for billing, internal and external reporting, research, and regulatory compliance activities. Resolves billing related errors and assists with workflow changes and process improvement projects. Meets ongoing productivity and quality standard of 95% accuracy rate or better. Verifies that all ICD-10 codes are correctly captured. Verifies that physician is correctly abstracted. Keeps abreast of coding guideline changes. Participates in internal and external quality review meetings. May identify chargeable items for facility level for given department. May assign codes for diagnoses and treatment for ancillary outpatient encounters.  Abides by the standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and adheres to all official coding guidelines. Performs other duties as assigned. Coder I may be asked to...