HCC Risk Adjustment Coder

Responsibilities:

· Review and accurately code medical records and encounters for diagnoses and procedures related to Risk Adjustment and HCC coding guidelines.

· Perform chart reviews for documentation completeness and ensure all applicable codes are captured.

· Determine the appropriate ICD-10-CM, CPT, and/or HCPCS and ensure documentation in the medical record follows official coding guidelines.

· Manage the provider query process to clarify documentation and ensure the completeness and accuracy of patient diagnoses, particularly related to chronic conditions.

· Collaborate with clinical teams to review documentation and provide insights on areas for improvement in coding and documentation.

· Maintain current knowledge of ICD-10-CM codes, CMS documentation requirements, and state and federal regulations.

Qualifications:

· Certification as a Certified Risk Adjustment Coder (CRC), Certified Professional Coder (CPC), or similar credential.

· Minimum of 2-3 years of experience in HCC/risk adjustment coding.

· Strong organizational skills

· Competence in basic computer skills, Microsoft Outlook, Word, Excel and Outlook.

· Proficiency with Athena Health electronic health record (EHR) system preferred

· Strong written and verbal communication skills