Risk Adjustment Coder Professional Billing II, FT, Days, - Remote
Job Summary
Counsults prospective review to abstract Hierarchical Condition Categories (HCC's) codes to report for the calendar year.
Communicates (via Epic and in person) with providers on any outstanding HCC capture opportunities.
Conducts retrospective reviews to ensure that documentation supports reporting the Hierarchical Condition Category code prior to payor submission.
Essential Functions
- Conducts prospective review of charts to identify HCC opportunity.
- Conducts retrospective review of charts to confirm documentation supports reporting.
- Utilizes payor specific software to assist in capturing HCCs.
- Communicates with providers about HCC opportunities for improvement.
- Identifies suspect conditions that would potentially support reporting an HCC.
- Participates in education offerings.
- Participates in monthly meetings.
Supervisory/Management Responsibilities
This is a non-management job that will report to a supervisor, manager, director or executive.
Minimum Requirements
- Education - High School diploma or equivalent or post-high school diploma / highest degree earned.
- Experience - Five (5) years professional fee coding experience.
Required Certifications, Registrations, Licenses
- Certified Professional Coder (CPC)
- Certified Risk Adjustment Coder (CRC)
Knowledge, Skills And Abilities
- Knowledge of office equipment (fax/copier).
- Proficient computer skills including word processing, spreadsheets, database.
- Data entry skills.
- Mental skills.
Work Shift
Day (United States of America)
Location
Patewood Memorial Hospital Facility 7002
Value-Based Care and Network Services Department
70028459
HCC Coding Services
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