ACDI Risk Adjustment Coding Auditor - Physician Revenue Integrity
Under the general direction of the Physician Services Coding Director, The HCC Coding Auditor will review medical records for accurate code selection, to include highest level of specificity, documentation validation, compliance with ICD-10 coding guidelines, and quality of care opportunities.
Required Minimum Knowledge, Skills, and Abilities (KSAs)
High School diploma or GED required; Associates Degree preferred.
Risk adjustment methodology experience required.
Successful completion of an accredited program through AHIMA or AAPC preferred. Credential required such as CPC, RHIT, RHIA, CPC-H, CCS, CCA or CIRCC.
CRC preferred or attained within in 1 year of hire.
Minimum of five (5) years of multi-specialty coding.
Working knowledge of Risk Adjustment methodology.
Experience in Quality/HEDIS/gaps in care preferred.
CPT/ICD-10 CM/HCPCS/modifier coding for physician professional charges. Required experience coding E/M’s.
Strong ability to apply broad guidelines to specific coding situations, independently, utilizing discretion and a significant level of analytical ability.
Knowledge of data collection methods and statistical reporting.
Ability to direct the processing, collection, maintenance and analysis of compiled information and the preparation of reports from this data.
Demonstrated ability to work independently and as part of a Care Team.
Ability to analyze data and interpret it to others.
Demonstrated high degree of accuracy in auditing and statistical analysis preferred.
Knowledge of legal and regulatory requirements of medical records preferred.
Experience using MS Office Suite.
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