Job Description

Review and analyze medical records and patient documentation to accurately assign Hierarchical Condition Category (HCC) codes. Collaborate with healthcare providers, physicians, and other professionals to clarify documentation and resolve coding queries related to HCC coding. Ensure compliance with coding guidelines, regulations, and industry standards specific to HCC coding. Develop a deep understanding of HCC coding guidelines, risk adjustment methodologies, and reimbursement policies through continuous education and professional development. Utilize coding software and electronic health record (EHR) systems proficiently and efficiently. Maintain confidentiality and adhere to HIPAA regulations when handling sensitive patient information. Stay updated on industry changes and best practices related to HCC coding. Communicate effectively with coding team members and healthcare professionals to ensure accurate and complete documentation for risk adjustment purposes. Contribute to quality improvement initiatives by providing feedback and suggestions for process enhancements. Requirements A bachelors degree in pharmaceutical sciences or a related field is required. Strong knowledge of medical terminology, anatomy, physiology, and disease processes. Familiarity with coding systems, such as ICD-10-CM and CMS-HCC, is advantageous but not mandatory. Excellent analytical and problem-solving skills to accurately identify and assign HCC codes. Attention to detail and ability to work with complex medical records to capture all relevant HCC conditions. Effective communication skills to interact with healthcare professionals, coding team members, and clients. Proficiency in utilizing coding software and electronic health record (EHR) systems. Ability to work independently and in a team-oriented environment. Strong organizational and time management skills to meet deadlines and manage multiple priorities. Commitment to maintaining coding accuracy and staying updated on industry changes. Relevant certifications, such as Certified Risk Adjustment Coder (CRC), are a plus, but not required for fresh graduates.

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