Risk Adjustment Coding Specialist II

<p style="text-align:left"><b>Job Description Summary</b></p><p style="text-align:inherit">‎ </p>To scrub patient charts prior to appts to surface chronic conditions for providers review<p style="text-align:inherit">‎ </p><p style="text-align:left"><b>How will you make an impact & Requirements</b></p><p style="text-align:inherit">‎ </p><ul><li><p>Perform prospective medical record reviews for clinical indicators supportive of an underlying diagnosis to be presented to a clinician for review during a subsequent face-to-face encounter.</p></li><li><p>Review the encounter level patient medical record and provider selected ICD-10-CM diagnosis codes in real time prior to claim submission to validate completeness and accuracy of provider selected ICD-10-CM codes.</p></li><li><p>Collaborate with healthcare providers and other stakeholders to clarify documentation and ensure accurate coding and reporting of diagnoses.</p></li><li><p>Stay updated on changes to Medicare guidelines, coding regulations, and reimbursement methodologies to ensure compliance and accuracy in coding practices.</p></li><li><p>Participate in coding education and training initiatives for staff to promote consistent and accurate coding practices across the organization.</p></li></ul><ul><li><p>Stays current on applicable coding and documentation guideline changes and rules.</p></li><li><p>This role is expected to maintain a consistent accuracy rate of 95% or higher and able to meet productivity standards established by leadership.</p></li><li><p>Perform other job-related duties as assigned by leadership.</p></li></ul><p></p><p>Pre-visit risk adjustment chart review for HCC's.</p><p>Required certification:  CPC-A, CPC or CRC</p>