Job Description

Summary:

  • Provides ongoing Medicare Risk Scoring Review and audits medical coding data
  • Reviews the work of coding staff to verify accuracy of  Hierarchical Condition Category (HCC) Coding and Quality/HEDIS measures
  • Conducts analysis to evaluate the accuracy and efficiency of coding practices
  • Contributes to the development of codes for patient billing
  • Provides coders with feedback on performance results
  • May also be required to provide training and education

 

Requirements:

  • Bachelor's Degree, certification as a medical coder and/or medical coding auditor (CPC/CPMA), and Certified Risk Adjustment Coder (CRC)
  • Minimum 3-5 years coding experience with Medicare Risk Adjustment
  • Must be computer literate and skilled in usen Microsoft Excel
  • Excellent communication skills
  • Ability to multi-task
  • Ability to work well with other coders, management, and medical providers
  • Have a strong knowledge of CPT and ICD-10 codes
  • Attention to detail is extremely important in order to ensure accuracy