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Risk Adjustment Coder
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- Through our high-touch approach to value-based care, we're moving beyond fee-for-service and helping tie the healthy outcomes of patients directly to healthier profitability for providers and health systems.
- The HCC Coder will ensure the accuracy and completeness of patient medical records, which are essential for risk adjustment and determining appropriate reimbursement in value-based care models.
- Reporting to the Supervisor, Risk Adjustment Coding & Education, the primary focus will be on reviewing and validating electronic based medical charts to ensure accuracy of the HCC codes captured.
- HCC Coding: Identify and code Hierarchical Condition Categories (HCCs) based on documented conditions to ensure proper risk adjustment and reimbursement accuracy.
- Conduct prospective and retrospective chart review audits on outpatient medical chart notes to ensure the accuracy and completeness of documentation that reflects accurate coding selection per ICD-10 CM guidelines/reporting, which substantiates HCC codes captured and submitted to CMS for reimbursement.
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