Risk Adjustment Coding Specialist - Remote
Company: Element Care
Location: Lynn
Posted on: March 12, 2023
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Job Description:
The Risk Adjustment Coding Specialist reviews and analyzing
medical records to identify relevant diagnoses and procedures for
distinct patient encounters. Involves interaction with physicians,
residents, advanced practice nurses, ancillary providers, coding
and HIM professionals and nursing staff. Incumbent uses ICD-10-CM
standards, codes and abstracts medical records for reimbursement
purposes and performs analysis and implement procedures which
ensure the accuracy of data submitted to government agencies for
determining risk adjustment payments. This position is full time
Monday thru Friday 8am to 4pm. ESSENTIAL DUTIES AND
RESPONSIBILITIES INCLUDE: Evaluates medical record documentation
for completion to ensure accuracy and compliance to meet CMS
standards. Compares past and present medical history of each
participant to maintain ICD-10 codes for optimal
reimbursement.Validates ICD-10 codes based on documentation to
ensure proper HCC codes are generated. Validates Current
Professional Terminology (CPT) codes on the "All encounter Data"
Serves as a resource for Element Care sites to address risk
adjustment and medical coding guidelines and updates.Conducts risk
adjustment data validation and audits to identify and resolve data
integrity issues.Analyzes provider coding trends to detect risk
gaps and opportunities for provider education.On site visits with
IDT to ensure participants' diagnosis codes are not dropped based
on Risk Scores and HCC reports.Collaborates with IDT on
documentation requirements in order to reach proper diagnosis codes
selection.Reviews bulletins, AAPC website, and periodicals, and
attends workshops to stay abreast of current issues and changes in
the laws and regulations governing medical coding and proper
documentation. Ability to create and maintain strong relationship
with IDT and maintain confidentiality regarding clinical
information.Work with IDT in regards to NextGen EHR.Identifies and
evaluates meaningful use within ICD10 functionality.Identifies and
evaluates meaningful use of CPT Coding for "All Encounter Data"
submission.Provides training to IDT in order to meet CPT coding for
"All Encounter Data" submission.Ability to work with multiple
software systems running reports and updating data. Project
Work.Works on multiple projects individually and as part of a team.
Meets project timeline expectations. Other responsibilities as
required.JOB SPECIFICATIONS:AAPC or AHIMA Certified, CPC. CRC
preferred.Maintain current AAPC or AHIMA credentials. Complete all
continuous education mandated by AAPC.ICD-10 proficiency
requirements met.Demonstrated analytical, problem solving, and
documentation skills. Demonstrated verbal and written communication
skills.Covid vaccine required. PI207772652
Keywords: Element Care, Lynn , Risk Adjustment Coding Specialist - Remote, Other , Lynn, Massachusetts
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