Risk Adjustment, HCC Coder, Auditor
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Job Description
HCC Auditor validating risk-adjustment codes and medical records for e4health healthcare clients. Reporting audit results and training coders and providers remotely.
Responsibilities:
- Complete quality assurance reviews for clients on internal or external coders, providers, or accounts
- Review patient medical records and validate HCC code assignments and potentially complete code capture for completeness and accuracy
- Follow official ICD-10-CM and Risk Adjustment guidelines
- Report quality results and track and trend educational opportunities
- Respond to client subject matter needs
- Provide educational support and training to coders and/or providers
- Maintain an auditing accuracy rate of 95% or better while meeting productivity standards
- Ensure diagnoses are accurate and complete according to ICD-10-CM Guidelines for Coding and Reporting
- Confirm codes to the highest documented level of specificity
- Work effectively within a team environment
- Comply with patient-record confidentiality and system-security policies
- Maintain required productivity and quality requirements
Requirements:
- Must possess an approved AHIMA or AAPC coding credential
- CRC (Certified Risk Adjustment Coder) preferred
- Minimum 4 years’ coding experience with 2 years specific HCC experience required
- Specialty experience may be preferred according to specific client needs
- 30-hour-per-week commitment preferred
- At least 2 years of remote experience recommended
- Knowledge of health systems operations, reimbursement methodologies, and coding conventions
- Advanced knowledge of HCC/risk adjustment, coding, and documentation requirements
- Ability to perform accurate and complete HCC/risk-adjustment chart audits
- Ability to identify and communicate trends in provider coding and documentation
- Strong written, verbal, presentation, communication, collaboration, analytical, problem-solving, organizational, time-management, and attention-to-detail skills
- Ability to self-motivate and self-direct
- Commitment to a team environment and adherence to company Core Values
- Must maintain coding credential requirements
- Applicants for U.S.-based positions must be legally authorized to work in the United States
- Visa sponsorship is not available
Benefits:
- Excellent salary
- Full benefits package
- 401(k) with company match
- Medical insurance
- Dental insurance
- Vision insurance
- Life insurance
- Short-term disability insurance
- Long-term disability insurance
- PTO policy
- Remote work from a home office environment
- Remote role with travel to field sites when required
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