What are the responsibilities and job description for the Risk Adjustment Documentation and Coding Auditor position at LHP MSO, LLC?
General Purpose: The individual holding this position is required to support and demonstrate their commitment to the Longevity Health Plan Statement of Purpose, which is: To improve the health and quality of life of nursing home residents by caring for their unique medical, social, and emotional needs.
The Risk Adjustment Documentation and Coding Auditor is responsible for developing the process and reporting for performing annual, periodic, or other coding quality assurance reviews of medical record documentation and coding to ensure appropriate capture of CMS Hierarchical Condition Categories (HCC) conditions applicable to Medicare Risk Adjustment reimbursement activities. This position requires the Auditor to use their expertise and national coding guidelines as reference in performing medical record coding audits, determining if there are variances to these guidelines as well as variance to Longevity documentation and coding policies/procedures in the Medical Record and putting plans in place with the provider to remediate the identified variances. Additionally, this position must use complex, critical thinking skills in their every-day work and have effective communication style with providers to affect change and ensure documentation and coding compliance.
This position is office based, may be remote, administrative in function and supports a significant component of Longevity’s Risk Adjustment Program Performance.
