7 cms hcc coder jobs found

Duties include performing audits of health status by performing primary source validation comparison of medical record documentation to the corresponding paid claim to ensure all risk adjusted diagnosis in the medical record and on the claim align and originate from a valid source.  Core duties and responsibilities include the following: Performs quality reviews on records to validate coding according to the International Classification of Diseases Manual (ICD-10) for diagnoses and coding guidelines. Review medical records to validate diagnosis on the claim are supported by the medical record documentation Review medical records to ensure all relevant diagnosis for a date of service were documented by the provider on the corresponding claim. Works individually and/or within a team to validate the health status which determines the risk score and HCC for health plan members including: Service Code Accuracy (CPT/HCPCS) Diagnosis Codes Accuracy for codes...

JOB SUMMARY: CDI Specialists will collaborate extensively with physicians, nursing staff, other patient caregivers, and medical records coding staff to improve the quality, specificity, accuracy and completeness of the documentation of care provided and coded. CDI Specialist will review medical records for opportunities for diagnosis clarification and validity as it pertains to DRG assignment, severity of illness, risk of mortality, and case mix data as well as timely, accurate and complete documentation of clinical information used for measuring and reporting physician and facility outcomes. These goals will be accomplished by chart review and query placement when appropriate following AHIMA guidelines and CorroHealth policies and procedures. This is a remote position ESSENTIAL DUTIES AND RESPONSIBILITIES:  Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended...

Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. Risk Adjustment Coding Specialists are an important part of the Team at Virtix Health. The HCC Coding Team Member will review medical records to abstract ICD-10 codes, specifically those that map to HCCs, RxHCCs, and ESRD models. Coders will follow Medicare guidelines, ICD-10-CM guidelines as well as client specific requirements. Equipment provided along with Encoder software with access to AHA Coding Clinic This is a remote position ESSENTIAL DUTIES AND RESPONSIBILITIES:...

Job Description Join our team as a Facility ED Coder! Role responsibilities include assessing documentation for each service rendered in the hospital’s place of service, in order to accurately code principal diagnoses (i.e. preponderance of care sequence), secondary conditions, procedures, and social determinant codes using American Hospital Association guidelines, Current Procedural Terminology guidelines, payer specific rules for commercial and/or Medicaid insurance, and drug administration for specified service lines impacting Florida’s enhanced ambulatory grouping.  This includes excellent working knowledge of revenue charge capture and the impact to hospital billing (i.e. soft vs. hard coded charges),working knowledge of revenue codes, relevant grouper function and financial impact;  assessment and entry of surgical charges (i.e. supplies, implants), and pharmacy charges (i.e. contrast, patient supplied, etc).   This position is remote. Applicants must...

Job Description Join our team as a Remote Outpatient Surgical and Observation Coder ! Role responsibilities include assessing documentation for each service rendered in the hospital’s place of service, in order to accurately code principal diagnoses (i.e. preponderance of care sequence), secondary conditions, procedures, and social determinant codes using American Hospital Association guidelines, Current Procedural Terminology guidelines, payer specific rules for commercial and/or Medicaid insurance, and drug administration for specified service lines impacting Florida’s enhanced ambulatory grouping.  This includes excellent working knowledge of revenue charge capture and the impact to hospital billing (i.e. soft vs. hard coded charges),working knowledge of revenue codes, relevant grouper function and financial impact;  assessment and entry of surgical charges (i.e. supplies, implants), and pharmacy charges (i.e. contrast, patient supplied, etc).   This is...