Review Medical Records Thoroughly Analyze patient charts, physician notes, lab results, and clinical documentation. Identify chronic conditions, comorbidities, and other relevant diagnoses for HCC risk scoring. Assign Accurate Codes Apply ICD-10-CM , CPC , CRC , and HCC coding standards to ensure precise representation of patient conditions. Ensure correct sequencing of primary and secondary diagnoses. Risk Adjustment & Compliance Follow CMS HCC risk adjustment guidelines for Medicare Advantage and other risk-adjusted programs. Ensure full compliance with HIPAA, coding compliance rules, and company policies. Documentation Validation & Clarification Review physician documentation to confirm coding accuracy. Query providers for missing or unclear documentation when necessary. Support Audits & Reporting Prepare and submit coding reports for internal and external audits. Correct coding discrepancies and implement feedback to maintain quality standards. Optimize Risk Capture Identify patterns or gaps in documentation to improve risk adjustment and revenue accuracy. Collaborate with care management teams to ensure high-quality coding. Maintain Confidentiality Handle patient health information with strict adherence to HIPAA guidelines. Ensure secure storage and transmission of sensitive data. Continuous Learning & Updates Stay current with coding updates, CMS rules, and HCC risk adjustment changes. Attend training sessions to maintain certifications and coding accuracy.
Code medical procedures using CPC, CRC, and HCC standards for risk adjustment. Maintain patient information confidentiality, ensure accuracy of ICD-10 diagnosis codes, validate documentation, and support audits and coding compliance. Provident fund Health insurance
Responsibilities: * Collaborate with healthcare providers on coding queries * Maintain confidentiality at all times * Ensure compliance with HIPAA guidelines * Accurately code medical records using HCC methodology Provident fund Annual bonus Health insurance