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Onsite HCC Auditor/ Coder Job in San Antonio, Texas

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Job Title: Onsite HCC Auditor/ Coder

Employer:HealthTexas Medical Group
Type:FULL TIME
Required Certifications:CCS-P,CPC:
Required Experience:3 to 4 years
Preferred Experience:3 to 4 years
Location:2961 Mossrock San Antonio 78230, TX, US
Date Posted:2/3/2020

The HCC Auditor/Coder will review medical records for accurate code selection, to include highest level of specificity, documentation validation, compliance with ICD-10 coding guidelines, and quality of care opportunities.

Role responsibilities:

  • Reviews outpatient medical records on both a retrospective and prospective basis to ensure documentation accurately reflects and supports code selection based on the ICD-10 coding guidelines, which are submitted to CMS for reimbursement based on the CMS Hierarchical Condition Categories (HCC) conditions that are applicable to Medicare Risk Adjustment reimbursement initiatives.
  •  Performs physician queries as needed in order to validate ICD-10 diagnosis codes and follows established physician query policy and procedure. 
  • Ensures the diagnosis codes for each chronic or major medical condition have been captured and submitted within the permitted CMS timeframe.
  • Safeguards medical records and preserves the confidentiality of personal health information.
  • Keeps current on changes in coding and reimbursement requirements for government programs and other third party payers. 
  • Ensures compliance with all applicable Federal and State laws and regulations related to coding and documentation guidelines for Risk Adjustment. 

Knowledge, Skills & Abilities

·       Risk Adjustment methodology experience preferred

·       Proficient knowledge of CMS-HCC Model and guidelines

·       Ability to interpret, analyze and abstract data/documentation

·       Ability to identify HCC improvement opportunities and provide feedback to physicians on proper clinical documentation, compliance, and coding guidelines

·       Excellent organization and problem-solving skills required.

·       Strong oral and written communication skills required.

·       Strong time management skills required.

·       Ability to work in a continuously changing environment.

·       Must possess a high degree of accuracy, efficiency and dependability.

·       Ability to work effectively as a team member.

Experience & Education

  • Must have a minimum of 3 years coding experience with at least 1 year HCC Risk Adjustment experience and successful completion of a coding certificate program from one of the following is required:  Certified Professional Coder (CPC); or Certified Coding Specialist - Physician (CCS-P)
High School diploma or equivalent required. Bachelor’s degree in related field preferred; and/or relevant equivalent and relevant work experience 

Applying

Natasha M Medel

HR Associate Recruiter

Health Texas Medical Group

2961 Mossrock

San Antonio, TX 78230

(210)731-4800

Natasha.medel@healthtexas.org

healthtexas.org 


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