Reviews patient records to ensure compliance with documentation standards and supports diagnosis and procedure codes
Conducts audits on abstracted files to verify accuracy and completeness of coding, ensuring adherence to guidelines and regulations
Demonstrates understanding of hierarchical condition categories (HCCs) and participates in quality coding initiatives
Qualifications & Requirements
Associates degree and 3 years of relevant health plan or provider office medical coding experience
In lieu of a degree, 5 years of relevant experience is acceptable
Proficient knowledge of CMS-HCC model and guidelines
Previous experience in auditing medical records
Coding Certification required (CRC, RHIA, RHIT, or similar) in good standing; ICD-10 proficient
Average salary estimate
$70000
/ YEARLY (est.)
min
max
$60000K
$80000K
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