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ProfessionalServices - Risk Adjustment Coder - 730500

ProfessionalServices - Risk Adjustment Coder - 730500

MindlanceVarious, FL
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Job Description

Story Behind the Need

  • What is the purpose of this team?
  • Describe the surrounding team (team culture, work environment, etc.) & key projects.
  • Do you have any additional upcoming hiring needs or is this request part of a larger hiring initiative?

Codes, abstracts and analyzes inpatient and / or outpatient medical records using International Classification of Diseases, Tenth Revision (ICD-) for CMS risk adjustment purposes.

  • Codes, abstracts and analyzes inpatient and / or outpatient medical records using International Classification of Diseases, Tenth Revision (ICD-). Always coding to the highest level of specificity.
  • Code in multiple lines of business such as Marketplace (ACA) and Medicare Advantage
  • Follows the Official ICD- guidelines for Coding and Reporting and has a complete understanding of these guidelines.
  • Follows CMS risk adjustment guidelines and has a complete understanding of these guidelines.
  • Understands the impact of ICD- codes on the CMS HCC risk adjustment model.
  • Ability to meet productivity and accuracy standards
  • Ability to defend coding decisions to both internal and external audits.

    • Performs other duties as assigned. Work environment is positive and engaging. Typical Day in the Role

  • Walk me through the day-to-day responsibilities and a description of the project (Outside of the Workday JD).
  • What are the performance expectations / metrics?
  • What makes this role unique?

    • Coders will work daily reviewing medical records abstracting HCCs for members.

    Coders will also work on additional special projects as needed dependent on business needs.

    Remote

    Accuracy : %

    Production : - HCC’s an hour Candidate Requirements Education / Certification Required : CPC or CCS Preferred : CRC Licensure Required : Preferred : Years of experience required : years of medical coding experience, risk adjustment knowledge is preferred.

    Disqualifiers : Not certified.

    Additional qualities to look for : Tech savvy – Knowledge of computer basics. Comfortable utilizing Microsoft (Word, Excel, Teams, Outlook)

    Ability to navigate through the ICD CM codebook. Candidates who are enthusiastic and pay close attention to detail, ability to work under pressure as we pivot between multiple projects dependent on business needs.

  • Top must-have hard skills stack-ranked by importance

    • Codes, abstracts and analyzes inpatient and / or outpatient medical records using International Classification of Diseases, Tenth Revision (ICD-). Always coding to the highest level of specificity. Follows the Official ICD- guidelines for Coding and Reporting and has a complete understanding of these guidelines. Ability to meet productivity and accuracy standards Candidate Review & Selection

  • Shortlisting process
  • Candidate review & selection
  • Interview information
  • Onboard process and expectations

    • Projected Manager Candidate Review Date : - days post shortlisting

    Type of Interviews :

    Teams Video Required Testing or Assessment (by Vendor) : Medical coding skills test Next Steps

  • Additional background check requirements (List DFPS or other specialty checks here)

    • n / a

  • Do you have any upcoming PTO?

    • My calendar is up to date

  • Colleagues to cc / delegate

    • Lavelle Roberts and Dianna Smith

  • Are there any training requirements (time off, alternate schedule, etc.)?

    • No training is during normal business hours.

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    Coder • Various, FL