Under the general direction of the Physician Services Coding Director, this position works to improve the quality of coding documentation and data in the medical record and HCC database. The ACDI Support Specialist reports on the accuracy and consistency of the data in accordance with accepted and established standards.
ACDI Support Specialists also record documentation to ensure compliance in the collection of outpatient diagnoses and services and complete documentation requests from invested parties (Medicare Advantage Plans, MSSP, MHACO, etc). This also includes reviews of ambulatory records to spot incomplete and/or inconsistent documentation for patients that could impact the code selection and resulting risk adjustment assignment. This includes extensive medical record review and interaction with providers, care team, coders, and other staff.
Active “at elbow” support and participation in team meetings and education of providers and staff is required. Report results, findings and recommendations to the Physician Services Coding Director and assists with the development of process improvements to maintain data quality.
Ideal candidate will have experience reading clinical charts and reviewing medical documents. Experience with clinical abstracting, medical coding and EPIC a plus.
This position requires a high attention to detail and will include both independent and group work. Those with experience working in medical records, population health, quality oversight and or as a release of information specialist are encouraged to apply.
This position is located at 4 Shape Drive, Kennebunk with schedule flexibility between the hours of 6:30am-4:30pm (Mon-Fri, 8 hour shifts).
High school diploma or GED required; Associates degree or certified Medical Assistant strongly preferred.
Three plus years’ experience in healthcare setting related to HCC Risk Adjustment and/or chart auditing.
Experience in documentation review and auditing.
Knowledge of Risk Adjustment methodology.
Experience in Quality/HEDIS/gaps in care preferred.
Effective problem solving, analytical skills and communication skills.
Demonstrated ability to work independently and as part of a Care Team.
Strong understanding of medical terminology.
Working knowledge of Microsoft Office suite.
- Required Minimum Knowledge, Skills, and Abilities (KSAs)