Review and analyze patient medical records, including provider documentation, diagnostic reports, and treatment plans.
Assign accurate ICD-10-CM diagnosis codes in compliance with CMS-HCC risk adjustment guidelines.
Ensure all coded diagnoses are supported by appropriate clinical documentation.
Identify gaps, inconsistencies, or missing documentation and initiate provider queries when necessary.
Maintain compliance with CMS, Medicare Advantage, and internal coding policies.
Meet established productivity, accuracy, and quality assurance benchmarks.
Utilize electronic medical record (EMR) systems and risk adjustment coding tools effectively.
Participate in internal and external audits, training, and continuous education initiatives.
Collaborate with providers and internal teams to improve documentation quality and coding accuracy.

Medical Coder