Default GeBBS Healthcare Solutions
Sacramento, CA
Job Description This is a flexible CMS HCC / Risk Validation Audit role for a seasonal project. Other opportunities for continued work may be available at the conclusion of the project. Flexible work hours - nights and weekends are acceptable.
Responsibilities Coders will review member and claim data validation aspects, which include :Member name, Member DOB, Gender, Dates of service, claim type, and provider signature
Coders will be presented with all risk-adjusting diagnoses billed on a claim for a particular date of service or inpatient stay
Must be able to identify acceptable provider specialty
Coder must have knowledge of ICD-10-CM IP and OP coding
Coders will confirm or not confirm each diagnosis
Coders will add risk-adjusting diagnoses that are valid but not reported
Requirements Active certification through AAPC or AHIMA is required
Minimum 5 years verifiable risk adjustment coding experience post certification
Must be able to maintain a 95% accuracy rate and 3 CPH
US-Based...