Senior Hcc Risk Adjustment Coder

Job Title: Senior HCC Risk Adjustment Coder

Department: Risk Adjustment and Quality

Effective Date: Sept. 9, 2023

Reports to: Risk Adjustment Manger

Direct Reports: None

FLSA: Exempt Working Conditions: Normal, no adverse or hazardous conditions.

To abstract information and assign ICD-9/10 CM codes from provider documentation and report data using specific software. This position will participate in internal & external record audits as directed and monitor systems and medical records to ensure they are current and provider documentation conforms to regulatory and procedural requirements. Coders work remotely but are required to conduct and attend local onsite trainings/audits/chart reviews at provider offices.

Position Responsibilities:

 Abstract coding information from EMR or handwritten medical charts effectively and efficiently. Provide feedback to Risk Adjustment Manager for provider education.

 Assist with required training in regards to regulations for coding medical documentation.

 Ensure that the codes are supported following Medicare and ICD-10-CM guidelines.

 Train and educate the Coding Department and Physicians as needed.

Requirements:

 Follow Risk Adjustment Data Abstraction Rules.

 Effectively utilize integrity and consultative skills to maintain excellent interpersonal relationships with the client, various departments and at all levels of the organization.

 Must have strong analytical, problem solving and research skills and the ability to utilize creative thinking.

 Must be detail oriented, and have the ability to work independently with highly confidential information per HIPAA regulations with minimal supervision.

 Manage and tracking of multiple tasks in an efficient manner to ensure completion of all assigned projects.

 Comply with all internal policies and procedures.

 Interacts face-to-face, over the phone and in writing with strong and polished professional communication skills.

 Must have a hard-wired internet connection (wireless not acceptable).

 Special projects and other duties as assigned.

MUST RESIDE IN SOUTHERN CALIFORNIA

Experience & Education

 MUST be certified through either the AAPC of AHIMA. (Apprenticeship designations are not accepted).

 Acceptable credentials would be CPC, CRC, RHIT, CCS OR CCS-P.

 2 years of auditing experience.

 Working knowledge and experience with systems such as EMRs, billing systems, abstraction platforms, etc.

 Team Member must be able to work from home and be independent in their coding skills

 Familiarity of state and federal laws, professional standards, and accreditation standards is necessary.

 Training program development and presentation skills preferred.

 Advanced Excel experience.

 Outlook: Ability to manage emails and schedule and attend meetings.

 Knowledge of medical terminology, human anatomy/physiology.

 Working expertise of fundamental principles of writing and grammar, including proper report and correspondence format, correct spelling and proper word usage, grammar, punctuation, and sentence structure.