Risk Adjustment Coder - Jacksonville, FL, US
17 hours ago
Job description
The HCC Professional Coder is responsible for:
· Review clinical documentation and assign accurate diagnosis codes according to CMS guidelines
· Verify the appropriateness of the ICD-10 code to include required supporting documentation and treatment plans
· Review medical documents such as progress notes, surgical reports, medical visits and diagnosis report in order to create educational strategies to ensure correct diagnosis code assignment by the provider
· Review medical records and billing history to determine if specific disease conditions were correctly billed and documented.
· Document detailed chart audit findings including all coding and documentation errors as well as any potential HCC opportunities.
· Improve coding accuracy by performing independent audits of physician records.
· Assist in developing strategic initiatives and training material tools related to HCC score improvement and accuracy for physician group
· Provide training to provider groups related to HCC documentation and coding
· Serves as a subject matter expert on MRA coding
· Perform other assigned duties/special projects on an as-needed basis.
Requirements, Skills and Abilities:
· Requires knowledge in Medicare Risk Adjustment (MRA) HCC coding documentation guidelines, rules and regulations
· Requires technical expertise in ICD-10-CM
· Prefer 2 years of HCC coding experience or Medical Assitant expereince
· Can appropriately use coding principles to code to the highest specificity
· Proven success in building relationships and establishing credibility with providers and other clinical staff
· Strong skills in medical record audit and review
· Understanding of healthcare data systems
· Strong proficiency with MS word and Excel
· Excellent problem-solving abilities along with written and verbal communication skills
· Strong collaboration and relationship building skills/Strong Team Player
· Ability to travel (day trips)
Minimum Education: A High School Diploma or Equivalent
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