Risk Adjustment Coding Specialist – Crc

Risk Adjustment Coding Specialist – Crc

Requirements

• AAPC Certified Professional Coder (CPC) certification is preferred, CPC and Certified Risk Adjustment Coder (CRC) is required
• Two years experience using ICD-9-CM/ICD-10-CM coding
• Knowledge of: Federal laws and regulations affecting coding requirements
• Principles, practices, and methods of current coding certificate required
• Knowledge of billing practices required
• Knowledge of medical records, and EHR required
• Extensive knowledge of official coding conventions and rules established by the American Medical Association (AMA), and the Center for Medicare and Medicaid Services (CMS) for assignment of diagnostic and procedural codes
• Must comply with all HIPAA rules and regulations

Responsibilities

• Performs chart audits to track ICD-10 coding and documentation to identify improvement opportunities and deficiencies related to Risk adjustment
• Evaluate the record for consistency and adequacy in documentation. Ensure that the final diagnosis accurately reflects the care and treatment rendered and that there is appropriate supporting documentation
• Identifies coding trends to be escalated to the coding and documentation educator and population health leadership
• Performs chart audits and data submission on payor portals as part of payer program incentive programs
• Performs a comprehensive review of the record to assure the presence of all parts such as patient and record identification, signatures and dates where required, and all other necessary data in the presence of all reports that appear to be indicated by the nature of the treatment rendered
• Answers internal and external complex coding email questions daily
• Maintains compliance standards in accordance with the Compliance policies
• Accurately follows coding guidelines and legal requirements to ensure compliance with federal and state regulatory bodies
• Performs other related duties, which may be inclusive, but not listed in the job description

Preferred Qualifications

• High School Diploma: Associate’s degree preferred
• AthenaHealth EHR experience a plus
• Excellent interpersonal skills, communication skills, analytical skills, and research skills
• Strong ability to collaborate, be resourceful, and team skills