Ambulatory Risk Adjustment Coding Specialist

Nso 4901 Searle Parkway Corporate Office Skokiemid

OtherRisk

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Quick Summary

Key Responsibilities

Review/abstract HCC codes to ensure they are coded accurately, to the highest specificity possible, and make sure the required MEAT is documented,

Technical Tools

OtherRisk

$22.14 - $33.21 - The hourly pay rate offered is determined by a candidate's expertise and years of experience, among other factors.

Position Highlights

Position: Ambulatory Risk Adjustment Coding Specialist
Location: Skokie, IL
Full Time
Hours: Monday-Friday, [hours and flexible work schedules]

Our Ambulatory Risk Adjustment Coding Specialist I plays a key role in identifying HCC codes within physician outpatient visits and ensuring they are coded accurately and to the highest specificity. They additionally will verify that documentation requirements are met to validate the HCC diagnosis code. Working closely with the ambulatory clinical documentation specialist (CDS), they will clinically verify the accuracy of HCC codes. Using compliant query guidelines, the coding specialist will query the physician should documentation need clarification or specification. The coding specialist is expected to maintain current knowledge of the ICD-10-CM codes and guidelines and meet minimum productivity requirements outlined by team leadership.

Responsibilities

~1 min read

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Review/abstract HCC codes to ensure they are coded accurately, to the highest specificity possible, and make sure the required MEAT is documented, resulting in the correct CMS-HCC risk score
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Identify diagnosis and chart level impairments and documentation improvement opportunities for provider education
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Responsible for partnering with ambulatory clinical documentation specialists and physicians to properly code patient charts to ensure appropriate risk adjustment
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Assist coding leadership by making recommendations for process improvements to further enhance coding goals and outcomes
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Assists the coding team leads with onboarding new coding specialists to the role as needed.
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Maintain current knowledge of ICD-10-CM codes, CMS documentation requirements, and state and federal regulations
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Consistently maintain a minimum 95% accuracy on coding quality audits
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Meet minimum productivity requirements as outlined by the project terms
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Utilizes technical coding expertise to assign appropriate ICD-10-CM diagnosis codes, as well as assist in appropriate assignment of risk adjustment
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Maintains advanced knowledge of coding all HCC diagnoses from the medical record in accordance with the ICD-10-CM coding guidelines
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Assists with and completes special project work as assigned by Ambulatory Clinical Documentation Leadership