Responsibilities:

• Compile chart review findings statistics, analyze data results, and implement action plans to improve providers’ performance levels
• Educate new staff to ensure high-quality data abstraction and chart reviews
• Develop quality assurance processes to ensure data integrity of all submitted diagnoses
• Evaluate and improve the effectiveness of risk adjustment coding programs, policies, and procedures
• Collaborate with inter-departmental team management to support coding initiatives related to risk adjustment programs
• Act as a Subject Matter Expert to identify opportunities for business enhancement in risk adjustment coding initiatives
• Keep management informed on current changes in regulations/guidance related to ICD-10 coding and quality documentation
• Interface with operations and clinical leadership to identify coding and documentation improvements
• Conduct mock audits targeting problematic diagnoses as identified by CMS and internal stakeholders
• Review medical records for completeness, accuracy, and compliance with coding guidelines and regulations
• Maintain department productivity and accuracy standards

Education Qualification:

• Current Registered Health Information Technologies (RHIT) or Certified Professional Coder designation from the American Academy of Professional Coders or a Certified Coding Specialist from the American Health Information Management (AHIMA)
• Bachelor's degree required

Required Skills:

• Proficiency in CPT-4, HCPC, ICD-9/ICD-10 coding
• Knowledge of medical terminology, procedures, abbreviations, and terms
• Understanding of the healthcare delivery system
• Ability to utilize a personal computer and software such as Word and Excel