Essential Duties and Responsibilities:
- Review clinical documentation and assign accurate diagnosis codes according to CMS guidelines
- Verify the appropriateness of the ICD-10 code to include required supporting documentation and treatment plans
- Review medical documents such as progress notes, surgical reports, medical visits and diagnosis report to create educational strategies to ensure correct diagnosis code assignment by the provider
- Review medical records and billing history to determine if specific disease conditions were correctly billed and documented.
- Document detailed chart audit findings including all coding and documentation errors as well as any potential HCC opportunities.
- Improve coding accuracy by performing independent audits of physician records.
- Assist in developing strategic initiatives and training material tools related to HCC score improvement and accuracy for physician group
- Provide training to provider groups related to HCC documentation and coding
- Serves as a subject matter expert on MRA coding
- Perform other assigned duties/special projects on an as-needed basis.
Requirements:
If you are looking to get off the floor and work in a business office environment we have a great opportunity for you!
Education and Experience Requirements:
- High School Diploma or Equivalent (Required)
- Requires technical expertise in ICD-10-CM
- Prefer 2 years of HCC coding experience
- Candidate must live in the Jacksonville, FL area
Knowledge/Skills/Abilities:
- Requires knowledge in Medicare Risk Adjustment (MRA) HCC coding documentation guidelines, rules and regulations
- Can appropriately use coding principles to code to the highest specificity
- Proven success in building relationships and establishing credibility with providers and other clinical staff
- Strong skills in medical record audit and review
- Understanding of healthcare data systems