Demo

CMS-HCC Risk Adjustment - Part Time

GeBBS
Virtual/Remote, Part Time
POSTED ON 11/4/2023 CLOSED ON 11/2/2024

What are the responsibilities and job description for the CMS-HCC Risk Adjustment - Part Time position at GeBBS?

Overview

Concurrent CMS-HCC Risk Adjustment Project - PT

 

GeBBS will provide final HCC Coding REVIEWS for Medicare and Medicare Advantage Plans in a CMS-HCC coding project and will be ongoing. 

 

We are currently accepting applications for the upcoming season.  Must have a minimum of 3 full years HCC experience post certification.  This is a part-time employee (W-2) status position.

Responsibilities

  • Minimum 20 hour part-time position (Monday 12:30AM Pacific - Friday 11:30PM Pacific - no weekends)
  • CONCURRENT CODING CMS-HCC 
  • Must comply with accepted coding practices as defined in the ICD-10-CM, AHA Coding Clinic®, and Client Coding Guidelines
  • HCC Coding - Coder will review, verify, reorder and add/remove dx codes if needed.
  • Medicare Plans
  • 16 encounters per hour
    • Single DOS (2023)

In a concurrent coding review process, coders review the EHR/medical notes and HCC codes in real time before the claims are submitted to payers. This process helps ensure the diagnosis coding accurately supports what the physician documented in the EMR.  In many cases, the physician will perform robust clinical documentation but may not select the most appropriate ICD-10 code.  Having the medical coding team perform this concurrent review prior to claim submission achieves two benefits. First, it ensures the physician's hard work in delivering and documenting care is correctly translated into accurate HCC codes. Second, it ensures the payers have the correct HCC codes on the initial claim, eliminating the need for an additional retrospective review.

Qualifications

  • Current CPC, CCS, RHIT, or RHIA or equivalent through the AAPC or AHIMA required
  • CRC preferred, but not required
  • Must have at least 3 years of active HCC coding experience post credential
  • Must have at least 3 years of ICD-10 coding experience
  • Experience coding both IP and OP charts
  • Experience coding oncology
  • Candidates will be required to pass a Risk Adjustment Coding Test
  • Must Pass Background check and drug screening
  • Must be able to maintain a 95% accuracy rate
  • US Based candidates only
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