Responsibilities:

Assign appropriate ICD-10-CM codes, mapping to risk adjustment models for Medicare Advantage and ACA Commercial Projects Assign flag events and CDI for documentation discrepancies Comply with the Standards of Ethical Coding as set forth by the American Health Information Management Association and adhere to official coding guidelines Comply with HIPAA laws and regulations Maintain quality (=>97%) and production standards Remain current on diagnosis and coding guidelines and risk adjustment reimbursement reporting requirements

 

Qualifications:

At least 6 months of medical coding experience (HCC Risk Adjustment) Must be college graduate with at least 6 months of BPO experience Active coding certification under AAPC or AHIMA; Certified Risk Adjustment Coding Certification (CRC) preferred Able to code using ICD-10 CM physical codebook or coding software Strong clinical knowledge related to chronic illness diagnosis, treatment, and management Able to work on graveyard shift