Job Description

Summary  

Certified Medical Coder role  is responsible for reviewing, abstracting, and coding inpatient and/or outpatient medical records to ensure proper ICD-10-CM, HCPCS, and CPT coding and compliance with Risk Adjustment requirements.  

Key Responsibilities  

• Follows CMS Risk Adjustment guidelines and has a complete understanding of their real-world   application  

• Reviews  submitted medical records to  identify ICD-10-CM diagnoses, ensuring the documentation   meets all CMS standard requirements for valid submission  

• Codes all diagnoses and services accurately and completely, from the medical record  in accordance   with the ICD-10-CM coding classification system  

• Selects and accurately records all  appropriate records and data on assigned chart abstraction projects  

• Ability to meet productivity and accuracy requirements  

• Performs other duties as assigned  

Qualifications  

• High School Diploma or GED  required   

• A certification in one of the following is  required :  

• Certified Professional Coder (CPC) 

• Certified Risk Adjustment Coder (CRC) 

• Certified Coding Specialist (CCS) 

• Registered Health Information Technician (RHIT) 

• Registered Health Information Administrator (RHIA) 

• Minimum of three (3) years HCC experience performing  concurrent and  retrospective risk adjustment chart review s   required  

• Current AAPC or AHIMA credential  required  

• Risk Adjustment / HCC knowledge  required  

• Managed Care experience preferred  

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