About this role
Role Overview
- Responsible for conducting complex audits, reviews and assessments of medical records
- Contributes to compliance reporting and documentation
- Demonstrated ability to apply coding judgment and make decisions using industry-standard evidence and tools
- Adhere to stringent timelines consistent with project deadlines and directives
- Serves as the training resource and subject matter expert to vendors, providers and team members for questions regarding ICD coding and documentation requirements
- Identify and communicate documentation deficiencies
- Acts as mentor to provide education to internal staff based on audit findings
- Communicates with corporate legal and compliance teams to ensure accurate reporting to external authorities
Requirements
- Minimum of 5 years recent and related experience in medical record documentation review, diagnosis coding, and/or auditing
- Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories (HCC) required
- Completion of AAPC/AHIMA training program for core credential (CPC, CCS-P) with associated work history/on the job experience equal to approximately 5 years for CPC
- CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist-Physician) and CRC (Certified Risk Adjustment Coder) required
- CPMA (Certified Professional Medical Auditor) or CDEO (Certified Documentation Expert Outpatient) preferred
- Experience with International Classification of Disease (ICD) codes required
Benefits
- Affordable medical plan options
- 401(k) plan (including matching company contributions)
- Employee stock purchase plan
- No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs
- Confidential counseling and financial coaching
- Paid time off
- Flexible work schedules
- Family leave
- Dependent care resources
- Colleague assistance programs
- Tuition assistance
- Retiree medical access