Humana
Denver, CO
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The Risk Adjustment Coder conducts quality assurance coding of medical records and ICD-10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. The Risk Adjustment Coder assumes ownership and leads advanced and highly specialized administrative/operational/customer support duties that require independent initiative and judgment.
The Risk Adjustment Coder ensures coding is accurate and properly supported by clinical documentation within the health record.
Reviewsmedical records toreport conditions that map toHCCs by reviewing medical record documentation and applying theappropriate ICD-10diagnosis codes.
Followsstate and federal regulations as well as internal policies and guidelines while analyzing coding information and medical records.
Works onprojects that may include making phone calls to providers.
Works within broad guidelines with little...