Risk Adjustment Coding Specialist supporting risk adjustment efforts through chart reviews and provider education. Estimated travel up to 75% in Inland Empire region, specifically LA or Orange County.
About the role
- Home health coder for Banner Health evaluating medical records and assigning diagnosis and procedure codes. Working with medical providers for accurate coding compliance and quality assurance.
Responsibilities
- Evaluate medical records, provide clinical abstracts, assign appropriate clinical diagnosis and procedure codes in accordance with nationally recognized coding guidelines.
- Analyze medical information from medical records, accurately code diagnostic and procedural information in accordance with national coding guidelines and appropriate reimbursement requirements.
- Consult with medical providers to clarify missing or inadequate record information and determine appropriate diagnostic and procedure codes.
- Provide thorough, timely and accurate assignments of ICD and/or CPT4 codes, MS-DRGs, APCs, POAs and reconciliation of charges.
- Abstract clinical diagnoses, procedure codes and documents other pertinent information obtained from the medical record into the electronic medical records.
- Provide quality assurance for medical records, assuring compliance with coding rules and regulations according to regulatory agencies.
- Compile daily and monthly reports; tabulate data from medical records for research or analysis purposes.
Requirements
- High school diploma/GED or equivalent working knowledge and specialized formal training equivalent to the two year certification course in medical record keeping principles and practices, anatomy, physiology, pathology, medical terminology, standard nomenclature, and classification of diagnoses and operations, or an Associate’s degree in a related health care field.
- Demonstrate a level of knowledge and understanding of ICD and CPT coding principles as recommended by the American Health Information Management Association coding competencies, and as normally demonstrated by certification by the American Academy of Professional Coders.
- Six months providing coding services within a broad range of health care facilities.
- Acceptable accuracy rate on the coding test administered by the hiring facility according to pre-established company standards.
- Effectively work with common office software and coding software and abstracting systems.
Benefits
- Comprehensive benefit package for all benefit-eligible positions
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
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