Auditor 2/ Coder - Bakersfield, United States - Heritage Provider Network
Description
Job Description
Under the direction of the Supervisor/Director of HCC/Coding, this position is responsible for auditing and validating visit chart notes for BFMC/CCPN as well as coding hospital and clinic charges as needed.
The Auditor2/Coder will communicate directly with Staff Model and IPA offices regarding proper coding and documentation including but not limited to HCC and Quality Initiatives The Auditor 2/Coder will interact with other departments and providers in a professional and friendly manner, to create and maintain a positive relationship with our internal and external customers.
1.1 Audit and Code ICD-10, CPT-4 and HCPCS codes to ensure proper documentation of HCC diagnosis codes and otherlanguage that must be included in order to validate a note as an HCC exam.
1.2 Communicate with providers regarding chart notes that need to be corrected in a timely manner (within one week of receiving and auding the chart notes).
1.3 Query providers for potential HCC codes and chart note corrections to ensure all appropriate HCC diagnoses are being captured for each patient.
1.4 Interface effectively with providers and staff on coding issues and HCC documentation issues.
1.5 Code both clinic visits and professional hospital visits for HMO patients.
1.6 Assist with training new staff on auditing/coding and overall workflow as well as current Auditor 1/Coders that may need additional training.
1.7 Audit Medical records for Staff Model and IPA providers for validation of all current HCC diagnosis on all Senior HMO Patients as well as other lines of business in the future that may have HCC component to them.
1.9 All other job duties as required
Requirements
8.1 High school diploma/certificate required.
8.2 Valid CPC, CCS-P or CMC coding certificate.
years of coding experience required with at least one year emphasis on HCC code validation required
8.4 Maintain membership and Continuing Education Unites (CEU's) for any Coding Credential(s) obtained. Reimbursement
will be given for membership and CEU's if employee turns in the original receipt for items purchased.
8.5 Comprehensive knowledge of CPT-4, ICD-10 and HCPCS codes and how to apply them.
8.6 Extensive understanding of Medical Terminology and Human Anatomy required.
8.7 Adherence to official Coding, CMS and other regulatory guidelines and mandates.
8.8 Ability to read and understand medical record documentation for HCC diagnoses extraction.
8.9 Intermediate skill level of Microsoft Word, Excel, Power Point, Outlook, and Access.
9.0 Knowledge of and adhere to HIPAA and Health Care compliance regulations.
The pay range for this position at commencement of employment is expected to be between $31.51 and $37.08 however, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, skills, and experience.
The total compensation package for this position may also include other elements, including a sign-on bonus, restricted stock units, and discretionary awards in addition to a full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave), dependent on the position offered.
Details of participation in these benefit plans will be provided if an employee receives an offer of employment.
If hired, employee will be in an "at-will position" and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department/team performance, and market factors.