Position Responsibilities Demonstrates knowledge of coding and documentation standards as well as CMS risk adjustment guidelines and HCCs (hierarchical condition categories)
Reviews medical record to ensure all diagnosis codes are documented for the assignment of a valid and accurate HCC for each episode of care
Regularly reviews Epic HCC and payor CSI (Clinically Suspect Conditions) reports
Queries and provides feedback and education to physicians when identifying documentation deficiencies to improve accuracy of risk adjustment coding
Demonstrates understanding of risk adjustment payment models
Uses clinical reasoning and critical thinking skills to discern the financial impact of a query in order to prioritize efforts most efficiently
Completes patient medical chart review within 24-48 hours of visit completion
Responsible for maintaining active status of coding credentials and completes annual continued education hours.
Observes work hours and provides proper notice regarding absences and tardiness
Maintains positive working relationship with Physician Practices, Managed Care and all other departments and communicates with office staff as needed.
Performs other related duties.
Qualifications License/Registration/Certification
CPC, CCS-P or CRC Certification Required
Education
High School graduate
Experience
Five plus years experience in Coding and Billing, Knowledge of ICD-10-CM and CPT
Benefits We believe in the physical and mental well-being of our employees and are committed to offering comprehensive benefits that fit their personal needs:
Health benefits
Life insurance
Long-term disability coverage
Healthcare spending accounts
Retirement plan
Paid time off
Pet Insurance
Tuition reimbursement
Employee assistance program
Wellness program
On-site housing for select positions and more!
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