Responsibilities:
• Can understand and translate CPT, HCPC, ICD-9/ICD-10 codes for HCC abstraction.
• Review medical records for completeness, accuracy and compliance with applicable coding guidelines and regulations.
• Identify, compile and code member/patient data, using ICD-9/ICD 10-CM and other standard classification coding systems.
• Support the collection and distribution of documentation and coding improvement tools for designated practice units as applicable.
• Support educational activities for internal stakeholders as necessary as subject matter expert on coding review/guidelines.
• Actively participate & engage in program improvement discussions and activities.
• Maintains department productivity and accuracy standards.

Qualifications:
• Requires current Registered Health Information Technologies (RHIT) or Certified Professional Coder designation from the American Academy of Professional Coders or a Certified Coding Specialist , P from the American Health Information Management (AHIMA)
• Requires 2 - 5 years of Medical Coding experience
• Requires a minimum of 2 years’ experience in Health Insurance/quality chart audits and/or Utilization Review
• Bachelor's degree preferred

Knowledge of risk adjustment is a must