Tech Stack

Description

You will serve as a bridge between providers, coders, and the revenue cycle to clarify clinical documentation and ensure accurate claim submissions. Your work directly improves patient care quality and clinical practice accuracy.

Requirements

• Minimum 3 years of ambulatory risk adjustment coding experience
• Preferred: Certified Risk Adjusted Coder (CRC)
• Considered: Certified Professional Coder (CPC) or Certified Coding Specialist (CCS)
• ICD-10-CM coding experience
• Ability to work independently with minimal supervision after training
• Knowledge of HCCs and risk models
• Proficient critical thinking, reasoning, and deduction skills
• Ability to navigate various electronic health records and utilize AI/NLP technologies
• Positive attitude and team player
• Ability to collaborate with providers

Responsibilities

• Possess expertise in how proper provider documentation drives coding accuracy for complexity and medical necessity
• Build strong working relationships with clinicians, administrators, and revenue cycle colleagues
• Abstract clinical data from medical record documentation to produce queries for missed medical diagnosis opportunities
• Conduct pre and post visit audit to ensure accuracy and completion of medical record documentation for claims submission
• Work independently with minimal supervision
• Leverage communication skills to bridge interrelated concepts and processes
• Understand various payment structures and reimbursement methodologies in outpatient settings
• Utilize EHR to prioritize encounters and accurately enter data in Dynamics Tool
• Maintain knowledge of current coding guidelines and methodologies: HCCs, ICD-10-CM, OIG mandates
• Possess extensive knowledge of medical terminology, anatomy, pathophysiology, pharmacology