HCC / Risk Adjustment Medical Coders
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Job Description
Remote HCC/Risk Adjustment Medical Coder reviewing medical records for accurate, compliant risk adjustment coding. Ensuring ICD-10-CM, CMS-HCC, HIPAA, and audit requirements are met.
Responsibilities:
- Review and accurately code medical records and encounters for diagnoses and procedures related to Risk Adjustment and HCC coding guidelines
- Ensure coding is consistent with ICD-10-CM, CMS-HCC, and other relevant coding guidelines
- Validate the completeness, accuracy, and integrity of coded data
- Identify and resolve coding discrepancies between clinical documentation and diagnosis coding
- Stay up-to-date with coding guidelines, rules, and regulations related to Risk Adjustment and HCC coding
- Adhere to compliance and HIPAA regulations to maintain data security and patient confidentiality
- Collaborate with healthcare providers, physicians, and other team members to clarify documentation and resolve coding queries
- Participate in coding education and training programs
- Prepare and submit reports related to coding activities, accuracy, issues, or trends
- Assist in internal and external coding audits
- Identify opportunities for process improvement and efficiency
- Offer suggestions to enhance coding documentation and accuracy
Requirements:
- Minimum CPC or CCS certification from AHIMA or AAPC is required
- CPC-A (Apprentice) certification will not be considered
- CRC (Certified Risk Adjustment Coder) certification is a significant advantage
- Minimum one to two years of experience in Risk Adjustment and HCC coding in a healthcare setting
- Strong knowledge of ICD-10-CM coding guidelines and CMS-HCC risk adjustment methodology
- Familiarity with electronic health record (EHR) systems and coding software
- Excellent attention to detail and analytical skills
- Ability to work independently
- Strong communication and interpersonal skills for collaboration with medical professionals and team members
- Understanding of compliance and confidentiality regulations, including HIPAA
- Availability to work from 6 AM to 6 PM EST
- Minimum commitment of 20 hours per week, Monday through Friday
- Windows-based laptop/desktop with Windows Professional Edition (Windows Pro)
- Reliable high-speed internet connection
- Windows Home Edition systems are not compatible with the role's security requirements
Benefits:
- Bring Your Own Device (BYOD) policy
- Minimum commitment of 20 hours per week; preference for candidates committing to 40 hours per week
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