HCC Coder

Job Overview
Responsible for auditing all Senior HMO members' medical records to ensure accuracy of Risk-Adjustment data and reimbursement. Maintain a professional, positive and caring attitude at all times

Duties

• Audit PCP, specialist and hospital records for additional HCC diagnoses.
• Audit all assigned providers wellness visits and send a CAP based on last year chronic conditions.
• Log the patients
• Prepare provider report card following completion of each PCP review utilizing comments function of qHMO.
• Forward provider report card to HCC Manager.
• Update encounter information with additional HCC data.
• Conduct Risk Adjustment Data Validation (RADV) audits as requested by HCC Manager.
• Orient providers in the use of qHMO and documentation for Risk Adjustment.
• Reinforce to providers the necessity for thorough and accurate documentation and reporting of Risk Adjusted diagnoses.
• Contact a provider when necessary to clarify medical record documentation.
• Attend required meetings and participate in committees as requested by management or administration of HVVMG.
• Enhance professional growth and development through in-service, educational programs and conferences.
• Maintain a current center for Medicare and Medicaid Services Hierarchical Condition Category, herein referred to as CMS-HCC guideline reference.
• Incorporate the ICD-10 yearly updates by October 1 of each year.
• Provide clerical support to HCC Manager as needed.
• Assist with training of HCC staff.

The pay range for this position at commencement of employment is expected to be between $21.61 and $23.50/hour; however, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, skills, and experience. The total compensation package for this position may also include other elements, including a sign-on bonus, restricted stock units, and discretionary awards in addition to a full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave), dependent on the position offered. Details of participation in these benefit plans will be provided if an employee receives an offer of employment.

• High school graduate or equivalent.
• Certified Professional Coder (CPC). Must maintain certification
• Completion of anatomy course preferred.
• Experience as a medical office/clinic professional coder preferred.
• PC knowledge of MS Office and Internet applications.
• Excellent written and verbal communication skills.
• Ability to handle and prioritize tasks in order to meet all given deadlines and productivity goals.
• Ability to responsibly handle matters of a confidential nature.
• Ability to work in a multi-task, high-stress environment