Hierarchical Condition Category (HCC) Coder - Galen Medical Group

07/13/2021 11:04 PM | Rebekah Francis (Administrator)

PURPOSE:    Provide review of the medical record post visit to ensure accuracy and inclusion of appropriate diagnosis codes in order to capture the complexity of the patient’s medical condition.  Audit records to assure compliant coding.

WORKING HOURS:

1.         Work hours can be PRN, Pro-rated FT or FT based on needs of the site.

2.         Weekends, holidays and overtime must be worked as required by department.

3.         Galen reserves the right to change the work schedule of any employee when it is considered in the best interest of the organization.

4.         The reasonable scheduling of overtime is the prerogative of Galen, and employees will be expected to work such overtime unless excused by their supervisor.

DUTIES AND RESPONSIBILITIES:

1.

Review medical records and decipher if they are accurate and complete, in support of patient risk adjustment score accuracy, verify and ensure the completeness, specificity and appropriateness of diagnosis codes based on services rendered, and assign appropriate ICD-10-CM codes, mapping to risk adjustment models as applicable.

2.

Assists practice leadership to analyze data, identify issues, reach conclusions, and propose strategies for resolution of complex coding issues.

3.

Communicates effectively with practice leadership regarding coding and documentation issues by assisting in the preparation of reports and memoranda regarding audit results and coding compliance matters.

4.

Knowledge of government, legal and regulatory provisions related to collection activities.

5.

Knowledge of government programs, i.e., Medicare and Medicaid.

6.

Knowledge of insurance company’s policies and procedures.

7.

Knowledge of CPT, ICD-10-CM, and HCPCS coding.

8.

Knowledge of anatomy and medical terminology.

9.

Strong clinical knowledge related to chronic illness diagnosis, treatment and management. Creative thinking skills, hands-on problem-solving skills and ability to analyze and respond to data.

10.

Effective communication skills at all levels within organization and excellent customer service skills.

11.

Extensive knowledge of ICD-10-CM outpatient diagnosis coding guidelines (knowledge and demonstrated understanding of Risk Adjustment coding and data validation requirements is highly preferred)

QUALIFICATIONS:

Education:  Must have a professional coding certification; CDEO certification preferred

 

Experience:  Minimum of 4 years coding experience required

 

Required Skills:  Excellent verbal and written communication skills, organizational, and

Interpersonal skills. Strong computer skills.

Qualified candidates please email your resume to: charles.lathram@galenmedical.com

 

OUR GOAL

To develop and equip our members to create dynamic, successful medical group practices.

OUR VISION

To be the recognized leader in defining and supporting the profession of medical practice management in Tennessee.

CONTACT US

PO Box 380963
Birmingham, AL 35238
rebekahfrancis@att.net

(573) 556-6111


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