- Nashville, Tennessee, United States
- 3+ years
Responsible for coding medical records for risk adjustment, regulatory compliance, and HCC diagnoses within a healthcare setting.
Responsibilities
- Review medical record information retroactively and prospectively to identify, assess, monitor and document claims and encounter coding information
- Ensure diagnosis codes for chronic or major medical conditions are captured and submitted within permitted timeframe
- Assess adequacy of documentation of claims and query outpatient provider claims to obtain additional documentation or clarify documentation
- Audit provider documentation of ICD-10 codes and quality metrics to ensure adherence with CMS guidelines
- Use coding principles to code to highest specificity and comply with CMS regulations and company policies
Requirements
- High School Diploma/Equivalent
- Bachelor’s degree
- Nice to have: CMS
- Nice to have: HHS