HCC Coding Specialist

Mô tả công việc

Health Choice exists to improve the health and well-being of the individuals we serve through our health plans, integrated delivery systems and managed care solutions. We strive to recruit and retain only the finest health care professionals with the highest levels of integrity, compassion and competency. If you are driven by your own personal commitment to these values and desire to work in a team-focused, collaborative and supportive environment – while still being valued for your individual strengths – Health Choice is the place for you. Equal Opportunity Employer Minorities/Women/Veterans/Disabled The Coder Specialist is to perform medical record reviews and abstract codes effectively from medical records for the purpose of ensuring quality and timely care of our members as well as correct reimbursement. Codes will be sequenced and assigned from ICD 9 / ICD 10 based on the code which most accurately describes each documented diagnosis. Coder will develop, maintain and prioritize the logistics schedule of retrieving medical records for the health plan.  Conducts medical charts and claims audits, identifying opportunities for improving individual member risk adjustment score accuracy. • Comprehensive understanding of HCC Coding rules, regulations and methodology • Accurately and efficiently conduct medical record review/abstraction services. • Communicates with physicians and office staff on records needed for chart chases. • Perform work duties remotely, working on site as necessary for additional training and on-going education. • Goal of 95% chart retrieval of members that have been seen within the past 12 months • Must have comprehensive understanding of: the contents of a typical medical chart, medical terminology and abbreviations, ICD 9 / ICD 10 coding conventions and guidelines, what constitutes adequate substantiation of a diagnosis, and appropriate providers, documents and facilities for proper code capture.