Role and responsibilities :
•Review of Medical records and assign/validate the appropriate clinical ICD-10-CM, CPT and HCPCS codes.
•Maintain accuracy, integrity and quality of coded patient data.
•Adhere to the company TAT for coding.
•Ensure code best suits the patient’s clinical condition according to coding regulations and patient’s recent
medical care, site of that care and procedures.
•Query providers as necessary to obtain accurate and complete documentation to facilitate optimal coding.
•Ensure coding is done at the highest appropriate level of specificity supported by the medical documentation and
monitor for opportunities to educate providers on documentation required for optimal specificity.
•Provide feedback and suggestions to providers regarding coding accuracy.
•HCC or ICD-10-CM coding experience is mandatory.
•CPT and HCPCS coding experience will be added advantage.
•Ensure compliance with and adhere strictly to all regulatory coding guidelines including:
a)ICD-10-CM Official Guidelines for Coding and Reporting
b)AHA Coding Clinics
c)CMS Medicare Part C instructions and requirements for diagnostic coding.
d)Following HIPAA and confidentiality of information.
•Minimum 1 year of outpatient coding experience with ICD-10-CM.
•AAPC/AHIMA certification for coding with proficiency in ICD-10-CM.
•Thorough knowledge of anatomy, physiology, pharmacology and medical terminology
•Abide by AHIMA and/or AAPC coding Code of Ethics
•Complies with Imagine policies, procedures
•Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
•1.5+ years’ experience in HCC coding.
•Familiarity with Medicare Risk Adjustment.
•Experience working with providers for documentation improvement.
•E/M coding experience.