|Skills:||CPC,CRC,Risk Adjustment,Medical Record Abstraction
|Specialties:||Risk Adjustment, CDPS/HCC/ICD10 Medical Record Abstraction, ICD 10 Proficiency, Medicaid, Medicare
|Required Experience:||3 to 4 years
|Preferred Experience:||3 to 4 years
The Medical Coding Specialist, Senior is responsible to abstract and code diagnosis information and/or medical conditions documented in physician office medical records using CMS, ICD and/or Department defined criteria and guidelines.
The Senior Specialist will receive and review medical records electronically and document ICD-10 codes or discern and apply appropriate error codes affecting completion of abstraction using computer software. The Senior level position will also be assigned abstraction and coding of medical records deemed too difficult for the Coding Specialist staff, due to medical record deficiencies, and will define and document corrective action suggestions for presentation to the provider.
The Medical Coding Specialist is responsible for meeting average daily production goals on all first level reviews while maintaining a minimum 95% accuracy rate on a consistent basis.
Three to five years including:
• a minimum of two years abstracting and coding medical records in a production environment for retrospective risk adjustment diagnosis modification
• a minimum of one year functioning as a medical record auditor
Required: Successful completion of at least one AHIMA or AAPC certification program with achievement of the correlating professional credential (CCS, CPC, etc.); active and in good standing.
Required: ICD-10 Proficiency validation.
Required: Certified Risk Adjustment Coder (CRC) credential.