SUMMARY:
Certified MRA Coder I, will perform Retrospective
Review to assist healthcare providers in identifying and resolving issues
related to incomplete or missing clinical documentation. Increase accuracy, completeness
and compliance with clinical condition documentation to enable providers to
deliver quality of care.
RESPONSIBILITIES/TASKS:
·
Ensures
compliance with all applicable Federal, State, and/or County laws and
regulations related to coding and documentation guidelines for Risk Adjustment.
·
Performs
on-site or in-office electronic medical record review to ensure capture of all
relevant diagnosis is based on CMS Hierarchical Condition Categories (HCC)
conditions that are applicable to Medicare Risk Adjustment reimbursement
initiatives.
·
MRA
coder will conducts audits to abstract data not submitted by providers.
·
Reviews
medical records, patient medical history and physical exams, physician orders,
progress notes, consultation reports, diagnostic reports, operative and
pathology reports, and discharge summaries
·
Focus
on retrospective coding to close HCC gaps and add HCC codes not reported.
·
Ensure
diagnosis codes are supported by the documentation and ensure adherence with
ICD-10CM Guidelines for Coding and Reporting.
·
Ensure
diagnosis codes for each chronic or major medical condition have been captured
and submitted within the permitted timeframe.
EMPLOYMENT QUALIFICATIONS:
EDUCATION:
High
School degree or equivalent required. Bachelor’s
degree in a related field preferred.
Successful completion of a coding license or certificates; CPC, COC, CRC,
CCS or RHIT. Continuous learning, as
defined by the Company’s learning philosophy, is required. Certification or progress toward
certification is highly preferred and encouraged.
EXPERIENCE:
One (1) year professional
coding experience. Experience and
understanding of CMS HCC Risk Adjustment coding and data validation
requirements. Successful
completion of a coding certificate program. CPC, COC, CRC from AAPC or CCS-P,
CCS, RHIT from AHIMA. Initial
demonstration and maintenance of continuing education/membership is required.
SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:
·
Excellent
organization and problem-solving skills.
·
Strong
oral and written communication skills.
·
Advanced
understanding of medical terminology, pharmacology, body systems/anatomy,
physiology, and concepts of disease processes.
·
Extensive
knowledge of ICD-10CM coding guidelines.
·
Advanced
technical skills for use of MS Office (Excel, Word, Outlook, and PowerPoint) as
demonstrated through successful completion of a skills test.
·
Demonstrated
ability to utilize a variety of electronic medical records systems.
·
Ability
to manage a significant work load, and to work efficiently under pressure,
while meeting established deadlines with minimal supervision.
·
Demonstrated
ability to communicate clearly and effectively with a wide variety of
individuals at all levels of the organization.
·
Strong
time management skills.
·
Must
possess a high degree of accuracy, efficiency, and dependability.
·
Excellent
written and oral communication for representation of clear and concise results.
WORKING CONDITIONS:
Work is performed
in an office setting with no unusual hazards.
The
qualifications listed above are intended to represent the minimum education,
experience, skills, knowledge and ability levels associated with performing the
duties and responsibilities contained in this job description.
We are
an Equal Opportunity Employer. Diversity
is valued and we will not tolerate discrimination or harassment in any form.
Candidates for the position stated above are hired on an "at will"
basis. Nothing herein is intended to
create a contract.