Risk Adjustment Certified Coder

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Job Type

Full-time

Description

This position requires normal business hours Monday-Friday. This is a remote position with occasional on-site meetings. Candidate must be able to maintain HIPAA privacy requirements when working from home. Candidate must be located in the Knoxville, TN region.

University Health Network is seeking a full-time Certified Medical Coder to join our team. This role involves performing detailed clinical documentation and risk adjustment reviews and accurately coding HCC diagnoses using ICD-10-CM guidelines. CPT and E/M experience is not required for this role.

Essential Duties and Responsibilities (this list does not include all duties assigned)

Performs coding services while meeting daily production and quality goals

• Conduct thorough reviews of clinical documentation to ensure accuracy and compliance with coding standards.
• Assign appropriate ICD-10-CM, CPT, HCPCS, and modifiers for professional services.
• Collaborate with healthcare providers to clarify diagnoses and procedures to ensure accurate coding.
• Use CMS and HHS risk adjustment mapping tools to identify HCC coding and documentation opportunities
• Participate in ongoing education and training to stay current with coding updates and guidelines
• Actively participates in designated team meetings
• Consistently meets coding productivity and accuracy standards while managing different responsibilities and workflows. If unable to maintain productivity and accuracy standards, team members will work onsite at the UHN office until standards are met and maintained.

Partners with providers, practice staff, and UHN Coding team to improve quality and efficiencies in coding and documentation

• Educates and coaches providers on compliant coding and documentation practices
• Facilitates and supports a culture of compliance, ethics, and integrity
• Recognized as an expert in medical coding, documentation, and risk adjustment compliance
• Interacts effectively and builds respectful working relationships across the organization.

Maintains HIPPA Guidelines for privacy

• Respects the privacy of all patients 100% of the time
• Understands and abides by HIPAA laws and regulations and UPA HIPAA policy at all times
• Obtains consent to release protected health information
• Reports all HIPAA issues to the Supervisor

Remains current on coding rules and guidelines

• Remains up to date with official AMA ICD-10-CM, CPT, and HCPCS coding guidelines and regulations, Medicare, other MA and commercial plans, and internal guidelines
• Remains up to date with CMS and HHS HCC risk adjustment models
• Meets CEU requirements and remains in good standing with AAPC/AHIMA certifications

Requirements

• Current CPC or RHIT certification required.
• CRC required within 6 months of hire
• Preferred at least two years of E/M and professional medical coding experience in an ambulatory care setting.
• Preferred experience and knowledge of HCC coding, knowledge related to chronic illness diagnosis, treatment, and management
• Must be a team player with effective written and verbal communication, relationship-building, and interpersonal skills
• Must be initiative-taking, highly organized, and have excellent time management
• Must possess good problem solving and critical thinking skills
• Exceptional attention to detail and proficiency in Microsoft Outlook (Outlook, Word, Excel, and PowerPoint)
• Demonstrates integrity by adhering to high standards of personal and professional conduct