MRA Coder

MRA Coder

The MRA Coder will be responsible for coordinating/supporting retrospective and concurrent chart reviews using knowledge of Hierarchical Condition Categories (HCC) coding to translate, input, extract and validate medical record data.

• Review patient medical history and physical exams, physician orders, progress notes, consultation reports, diagnostic reports, operative and pathology reports, and discharge summaries in order to verify whether the diagnosis codes are supported by the documentation to ensure they are within Guidelines for Coding and Reporting
• Schedule chart reviews with Physician practices
• Assist in obtaining medical records from Physicians to support audits requested by Health Plans
• Ensure compliance with all applicable Federal, State and/or County laws and regulations related to coding and documentation guidelines for Risk Adjustment.
• Educate Physicians regarding proper billing and documentation policies, procedures, and conflicting/ambiguous or non-specific documentation
• Demonstrate the ability to quickly identify low risk scores; incorrect coding and compliance trends; to analyze and investigate suspected problems with resolve; and to forward problems to the attention of the Medicare Risk Adjustment Director
• Performs other duties as required.

Requirements:

• CPC /CPMA/ CRC/ CCS-P/ CCS/ RHIA or RHIT certification
• Minimum 3 years of Medicare Risk Adjustment coding
• Advanced Microsoft Excel
• Familiar with HCC Dashboard tool
• Strong knowledge of ICD-10 and CPT codes
• Fluent in English and Spanish
• Clean driving record and reliable form of transportation