Coding Support Specialist - Summit Medical Group

About the role

Summit Medical Group is seeking a Risk Adjustment Coding Support Specialist to perform a comprehensive documentation review of outpatient Progress Notes for assigning the appropriate ICD-10 diagnosis codes for accuracy of disease burden. This is a full-time, onsite opportunity in the Knoxville, TN area.

Responsibilities

• Review clinical documentation in progress notes for accuracy of diagnosis coding to the highest level of specificity in a timely and efficient manner.
• Through progress note and electronic health record reviews, accurately correct/assign diagnosis codes to ensure ICD diagnosis coding and clinical documentation criteria, rules, and guidelines have been met in accordance with policy.
• Identify and report trends observed in progress note reviews for educational opportunities in clinical documentation specificity, diagnosis coding to the highest specificity, and provider feedback for improvements, training, and educational opportunities.
• Maintain continuous, effective, positive, and appropriate communication to prevent risk for the organization.
• Read clinical documentation to accurately assign diagnosis code specificity for severity of illness to report disease burden to CMS via diagnosis codes, meeting all documentation requirements as part of risk mitigation and prevention.
• Actively participate in applicable meetings, webinars, and communications to remain updated on diagnosis coding rules and documentation changes from credible sources. Independently seek CEUs if needed to maintain credentials with AAPC/AHIMA.
• Participate in site-level Quality Improvement Activities, contributing to the evaluation of site performance and implementation of improvement activities that increase the quality of care provided to patients.
• Take accountability as a certified professional to review all clinical documentation ethically and thoroughly within progress notes using applicable tools and communications for capture of full disease burden.

Requirements

• Associate’s degree; bachelor’s degree preferred.
• Completion of college/accreditation-level coursework in ICD-9-CM, ICD-10-CM, CPT coding, anatomy and physiology, and medical terminology.
• Experience with CMS Medicare Advantage Risk Adjustment Data Validation and HCC coding desired.
• ICD-10 diagnosis coding experience in chart/progress note review.
• Experience with risk adjustment, clinical documentation review for accuracy of diagnosis code assignment.
• Health plan Risk Adjustment processes and system experience for CMS RADV and risk score assignment and acceptance are helpful.
• Proficient computer skills.

Qualifications

• Must hold a current credential for one of the following: RHIA, RHIT, CCS, CCS-P, CPC, CPC-H, and/or CRC.
• If not CRC certified, must attain the certification within the first year of employment.
• Certification must be maintained by fulfilling continuing education requirements and submitting current proof.