JOB DESCRIPTION
Annual Health Assessment HCC Coder
Medical Coding Specialist – HCC Coder working under the direction of the Supervisor, determines the appropriate ICD10-CM diagnoses codes based on clinical documentation that follows the Official Guidelines for Coding and Reporting and Risk Adjustment guidelines for Hierarchical Condition Categories (HCC). HCC Coding is a risk adjustment model designed to estimate future costs for patients. HCC coding relies on ICD-10-CM coding to assign risk scores to patients.
Job requirements:
- High School Diploma and Medical Coding Education
- Certified Risk Adjustment Coder (CRC) or Certified Professional Coder (CPC) and/or Certified Clinical Documentation Specialist- Outpatient or Certified Documentation Expert Outpatient (CDEO) Certified Coding Specialist (CCS), or Certified Coding Specialist Physician-Based (CCS-P), or a Certified Coding Associate (CCA) required
- Minimum One (1) year of progressive coding experience; Preferred Two (2) years progressive coding experience in multiple specialties, HCC Risk adjustment Coding
- Experience with an Electronic Medical Record (EMR) and Argon Software (preferred)
- Knowledge of Annual Health assessment (AHA) coding guidelines and methodologies: HCCs, ICD-10-CM coding guidelines
- Extensive knowledge of medical terminology, anatomy, and pathophysiology, pharmacology, and ancillary test results
- Self-motivated and able to work independently without close supervision
- Experience in Excel and word documents
- Must have good verbal communication skills.
- Strong organization and analytical thinking skills – detail oriented
- Must have knowledge of 10-Key by touch and 40 wpm typing skills.
- Knowledge of all HIPPA rules and regulations.
Major Responsibilities:
- Review documentation of every Annual Health Assessment in the Medical Record and Medical Diagnosis Report (MDX) to ensure accurate codes and documentation are applied to the encounter for billing.
- Utilize available encoder, software, and other coding resources to determine the appropriate ICD-10-CM diagnosis codes mapped to HCCs.
- Maintain coding quality and productivity processes
- Audit and upload AHAs daily
- Complete required minimum 65% Annual Health Assessments (AHA) by June 30th.
- Complete required minimum 90% Annual Health Assessments (AHA) by December 30th.
- Collaborate with Medical Director on retrospective medical record review for severity, accuracy, and quality issues.
- Ensure documentation in the medical record follows the official coding guidelines and internal guidelines
- Participate in educational services relating to coding and documentation compliance as well as new policies and procedures.
- Participate in AHA training and RAF meetings provided by OPTUM.
- Submit quarterly reports of AHA totals by provider to Administration
Job Type: Full-time
Pay: $27.00 - $32.00 per hour
Benefits:
Experience:
- Medical Coding: 1 year (Required)
License/Certification:
- AAPC or AHIMA certif. or CCS or CPC Certified Coder (Required)
Work Location: In person