Risk Adjustment Coder(HCC)
7 days ago
Responsibilities:
Assigns diagnosis codes according to the Official ICD-10-CM Guidelines for Coding and Reports for conditions which map to the Center for Medicare & Medicaid Services’ Hierarchical Condition Categories (CMS-HCC) applicable for the year(s) of service being reviewedConducts thorough review of charts by effectively using computer-assisted coding tools to review and interpret medical records, and applies in-depth knowledge of coding principles to assign valid diagnosis codes which are supported by evidence in the medical record on the same date of serviceDemonstrates knowledge of what constitutes a medical record acceptable for supporting CMS-HCCs, including signature guidelines, member identifiers, provider types, medical record encounter/visit types, and places of serviceDemonstrates advanced knowledge of medical terminology, anatomy and physiology as they pertain to assigning appropriate codes and identifying pertinent supporting information in the medical recordManages individual quality of work & productivity toward meeting or exceeding targets.Performs administrative tasks and work as directed by Team Lead/Operations Lead/Quality Lead.Consults Team Lead/Operations Manager and/or Coding SME timely and appropriatelyWork Arrangement:
Hybrid, twice a week onsite - BGC TaguigMidshift (1pm - 10pm)Requirements:
Education: Associate Degree or equivalent HCC coding experienceComputer proficiency (including MS Windows, MS Office, and the internet)Ability to use an official ICD-10-CM code book or Encoder software which corresponds to the date(s) of service being reviewed to assign diagnosis codes appropriately and according to official guidelines and section/chapter level instructionsKnowledge of and ability to apply ICD-10-CM outpatient diagnosis coding guidelinePreferred Skills/Experience:
Knowledge of Hierarchical Condition Code conceptsKnowledge of HIPAA, recognizing a commitment to privacy, security and confidentiality of all medical records and member information.Knowledge and demonstrated understanding of CMS HCC Risk Adjustment coding and data validation requirementsEMR/EHR experienceRelated outsourcing/vendor operations experience2 years risk adjustment coding experience-
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