HCC Risk Adjustment Coder

Hcc Risk Adjustment Coder

Location:

Hybrid - Verona, NJ & Remote

Schedule:

Monday through Friday; 40 hours/week

Employment Type:

Full Time;
Exempt

Reports To:

Director, Clinical Quality & Transformation The HCC Coder is an essential administrative member of our dynamic health care team, focused on supporting the activities of the Population Health Department through various clerical duties. Excellent time management and an ability to work as part of a team are essential skills for this role. Willing to train the right candidate.

ESSENTIAL DUTIES AND RESPONSIBILITIES (included but not limited to):

Accurate data management including the retrieval of hospital records and obtaining reports from specialists and health care providers.

Manage data entry on multiple spreadsheets to track workflows and outcomes.

Ability to review documentation and abstract all codes with specific emphasis on identifying the most accurate severity of illness according to CMS HCC (Hierarchical Conditions Categories) guidelines.

Effectively uses computer assisted coding tools to review and interpret medical records and applies in-depth knowledge of coding principles to validate missing, incomplete or incorrect CPT and diagnosis codes.

Abstracts, sequences and assigns diagnosis and procedures codes according to CMS HCC and all CPT and ICD 9 & 10 guidelines.

Demonstrates advanced knowledge of medical terminology, anatomy and physiology.

Follows up on all outstanding and incomplete provider billing summaries to ensure proper coding.

Attend training, meetings and presentations associated with the Population Health Department and the Vanova Health organization as required.

Perform administrative duties including copying, report collation, organizational tasks, and other duties as assigned by Manager.

Serve as the subject matter expert on HCC documentation requirements and ICD-10 coding guidelines.

Strong understanding of the HCC concepts and impact on Population Health Risk Adjustment reimbursement initiatives.

Effectively use computer assisted coding tools to review and interpret medical records and apply knowledge of coding principles to validate missing, incomplete, or incorrect CPT and diagnosis codes.

Assists in orienting, training, and mentoring new staff and physicians.

Review HCC suggestions from 3rd party HCC platforms daily. Advance suggestions to providers based on patient's documented history. Suggestions must be reviewed prior to a patient next visit.

Demonstrates knowledge of medical terminology, anatomy, and physiology.

Follows up on all outstanding and incomplete provider billing summaries to ensure proper coding.

Ascertain that coding efficiency and accuracy are improved by performing independent audits of physician records.

Maintain at least 95% on both coding accuracy and completeness audits.

Ensure individual compliance with all privacy and security rules and regulations and commit to the protection of all Personal Health Information.

Office setting, with extended periods of sitting and computer work

Associate's degree minimum, bachelor's degree preferred

Work experience in a community or medical health care setting is a plus.

Previous HER knowledge required, Athena a plus1year of auditing experience

Proficient use of Microsoft Office Applications (Excel, Word, PowerPoint).Coding Certification (CPC, CRC, CCS-P, CCA, RHIT, or RHIA) highly preferred.

At Vanova, we see Total Rewards as more than just a paycheck and recognize that value comes in many forms. It is the full experience of being a part of our incredible team working toward a shared, mission-driven purpose.

We’re proud to offer competitive compensation, health and…