Responsibilities:
Review and accurately code medical records and encounters for diagnoses and procedures related to Risk Adjustment and HCC coding guidelines.
Perform chart reviews for documentation completeness and ensure all applicable codes are captured.
Determine the appropriate ICD-10-CM, CPT, and/or HCPCS and ensure documentation in the medical record follows official coding guidelines.
Manage the provider query process to clarify documentation and ensure the completeness and accuracy of patient diagnoses, particularly related to chronic conditions.
Collaborate with clinical teams to review documentation and provide insights on areas for improvement in coding and documentation.
Maintain current knowledge of ICD-10-CM codes, CMS documentation requirements, and state and federal regulations.
Qualifications:
Certification as a Certified Risk Adjustment Coder (CRC), Certified Professional Coder (CPC), or similar credential.
Minimum of 2-3 years of experience in HCC/risk adjustment coding.
Strong organizational skills
Competence in basic computer skills, Microsoft Outlook, Word, Excel and Outlook.
Proficiency with Athena Health electronic health record (EHR) system preferred
Strong written and verbal communication skills
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