Coder (HCC Certified)

Job Title: Risk Adjustment Medical Coding Auditor

Job Location: Albuquerque, NM (on-site)

Pay Rate: $18-$24 Hourly (Depending on Experience)

Job Summary:

Candidate will perform medical coding quality assurance reviews and audits. This will include completing medical record documentation to ensure the proper coding of CMS Hierarchical Condition Categories (HCC) are applicable to Medicare risk adjustment reimbursement activities.

Responsibilities:

• Must demonstrate high knowledge of medical coding in multiple areas of specialties.
• Translates ICD-9 codes into ICD-10 codes.
• Reviews patients' entire current medical record, assigning appropriate codes including CPR, lCD and MS-DRG (as defined by UHDDS guidelines and CMS) to be used for financial reimbursement, research in accordance with Federal Regulations and Hospital and Departmental policies.
• Abstracts data essential to the QI department in determining patient care as well as providing information to The Joint Commission.
• Accesses several systems in order to research the medical record and complete the coding in a timely manner.
• Maintains and disseminates up-to-date technical knowledge of legal and regulatory information from all appropriate jurisdictions concerning the given business area. This includes but is not limited to all ICD-9/10 CM, CPT-4, HCPCS, and DRG, APC and/or HHRG updates and changes.

Requirements:

• Certified Medical Coder through AAPC or AHIMA
• 2 year experience in HCC coding
• 1 year experience in auditing (preferred)
• Proficiency in MS Excel and Access (preferred)
• ICD-10 certified or performed ICD 10 training