Risk Adjustment Coder

October 26

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ExactCare

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Chronic Care Pharmacy-at-Home • Medication Management for High-Risk Patients • Medication Therapy Management • Gaps in Care • STAR Ratings Adherence Improvement

501 - 1000 employees

Founded 2009

⚕️ Healthcare Insurance

💊 Pharmaceuticals

💰 Private Equity Round on 2016-03

Description

• Review, analyze, and code diagnostic and procedural information from medical records. • Perform ICD-10-CM, CPT and HCPCS coding for reimbursement. • Ensure compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines. • Perform medical record reviews and use coding principles to code to the highest specificity. • Perform risk adjustment data validations using AHA coding guidelines. • Interact with clients and co-workers to communicate value added information and maintain strong partnerships. • Be a constant learner, performing research and staying abreast of updates.

Requirements

• Possess valid Certified Coding Specialist designation (CCS) issued by the American Health Information Management Association, Certified Professional Coder (CPC) designation, Certified Professional Coder Apprentice (CPC-A) designation or CCA designation with at least one year of coding experience. • Being a Registered Health Information Administrator (RHIA) is a plus. • Possess at least 6 months experience coding ICD-10 CM. • Have experience with MS Word, Excel, PowerPoint, and be comfortable learning and becoming an expert on new and proprietary software. • Have strong written and verbal communication skills, including propensity to establish and build strong relationships. • Take initiative to establish priorities, coordinate work activities and perform multiple and complex tasks while working independently and with minimal supervision in a remote setting. • Be detail oriented and quick to follow instructions and learn new tasks. • Possess a strong work ethic with impeccable integrity. • Documentation Improvement experience, experience in Hierarchical Condition Categories (HCC), knowledge of or experience in Medicare Advantage plans and knowledge of or experience in managed health care systems, PACE or Medicare are a plus.