Job Description

Provide coding support, education and training related to, quality of documentation, level of service and diagnosis coding consistent with established coding guidelines and standards. Maintain a comprehensive tracking and management tool to track all HCC activities and ensure that all tasks are completed in a timely manner. Verify and ensure the accuracy, completeness, specificity, and appropriateness of diagnosis codes based on services rendered. Review medical record information to identify all appropriate coding based on CMS HCC model. Comprehensive understanding of data systems and reporting for health record coding Serves as a resource and subject matter expert to coding staff Responsible for training and performance management Assists with any coding related audits Manage the coding workflow for efficiency Support and participate in process and quality improvement initiatives. Performs AHIMA compliant queries to providers when necessary Apply post-query response to make final determination Participate in ongoing training and education within assigned timeframe Maintains up-to-date knowledge of changes in coding and reimbursement guidelines and regulations Educate and mentor others to improve medical coding quality Participate in audits of coded data to validate documentation support services rendered for reimbursement and reporting purposes. Researches, analyzes, recommends, and facilitates plan of action to correct discrepancies and prevent future coding errors Demonstrates ability to work independently with minimal supervision Manages special projects as requested by leadership Communicates to leadership issues and barriers to completing all work processes Provide excellent customer services skills, including consistently displaying awareness and sensitivity to the needs of internal and/or external clients. Proactively ensuring that these needs are met or exceeded. Consistently demonstrates attention to detail and accuracy in work product by meeting or exceeding productivity standards and maintaining a company standard of accuracy Qualifications, knowledge, skills, and abilities: Advanced understanding of medical terminology, body systems/anatomy, physiology, and concepts of disease processes. In-depth knowledge of coding process, coding system software, workflow management and electronic medical records Demonstrate analytical and problem-solving ability regarding barriers to receiving and validating accurate HCC information. Interpersonal skills necessary to provide effective leadership to departmental personnel

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