HCC Coding Quality Speciailst

About Us:

Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals.

We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success.

JOB SUMMARY:

ESSENTIAL DUTIES AND RESPONSIBILITIES: Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.

Location: Remote within US only

All HCC/Risk Adjustment auditors MUST be certified through either the AAPC or AHIMA. (Apprenticeship designations are not accepted.) Acceptable credentials would be CPC, CRC, CCS, or CCS-P AND have at least 3 years of HCC coding experience with 2 years of auditing experience. Global experience preferred.

Job Summary:

Ensure that the codes captured are supported by the documentation within the record and are properly coded following Medicare guidelines, ICD-10-CM guidelines as well as client specific guidelines for the project.

Support your findings in a way the coder can easily identify and learn from the error.

Have strong and professional communication skills.

Be a resource for HCC coding team members by having a deep understanding of the project and coding guidelines.

Follow Risk Adjustment Data Abstraction Rules.

Assist with the creation of PowerPoints presentations for training purposes.

Will be required to maintain a quality score of 95% or higher.

Will be required to maintain an ongoing productivity level based on project requirements.

Ensure individual compliance with all privacy and security rules and regulations and commit to the protection of all Company confidential information, including but not limited to, Personal Health Information.

Align conduct with AHIMA's Standards of Ethical Coding and the Company’s Code of Ethics and Business Conduct and support the Company’s Ethics and Compliance Program.

Comply with all internal policies and procedures.

Regular, predictable, and punctual attendance is required.

Qualifications:

All auditors MUST be certified through either the AAPC or AHIMA. (Apprenticeship designations are not accepted.) Acceptable credentials would be CPC, CRC, CCS, or CCS-P.

Must have at least 3 years of