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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