HCC Risk Coder (CDIS)

Qualifications

• High school diploma or GED
• Active CRC (Certified Risk Adjustment Coder) or CPC (Certified Professional Coder) preferred
• Understanding of medical coding and documentation regulations
• Administrative, written, verbal, and typing skills
• Documented training in Medicare Risk Adjustment (MRA), HCC coding documentation guidelines, rules, and regulations
• Two years of demonstrated experience in a medical or health plan environment
• Excellent computer skills, including Outlook, MS Office, MS Excel, and MS Word

Responsibilities

• Review documentation to translate chronic conditions into appropriate diagnosis codes from outpatient medical records
• Extract data for Health Plan reports and input data from HCC programs
• Obtain medical records from providers to support Health Plan audits
• Help coordinate training sessions for physicians and staff on coding guidelines and compliance standards
• Verify that HCC codes are accurate and meet documentation guidelines
• Assign appropriate ICD-10-CM codes that map to risk adjustment models
• Identify documentation discrepancies and query providers for clarification when needed
• Participate in clinical documentation improvement initiatives
• Attend team meetings regularly
• Complete special projects and other assigned duties

Benefits

• Medical insurance for employee and spouse/significant other paid up to 100% by the employer
• Family coverage available at a reduced cost
• $25,000 life insurance for employees paid 100% by the employer
• Dental and vision coverage available at low cost
• 401(k) retirement plan with 100% match up to 4% of annual pay
• Paid holidays
• Paid time off for vacation, sick, and personal days