HCC Coder II

Arizona Priority Care; Chandler (AZ); On-site; USD 39,000 - 44,000; Full time

Job summary

Arizona Priority Care is seeking a skilled HCC Coder II to review outpatient and inpatient documentation for accurate CMS reporting and to identify all relevant HCC diagnoses. The role requires AHIMA or AAPC certification and 2 years of HCC coding experience.

The position starts FT in-office for the first 60 days with a hybrid schedule after training, offering a competitive hourly range and opportunities for quality-improvement work.

Qualifications

• Must have AHIMA or AAPC coding certification.
• Two years of HCC coding experience required.
• Experience with ICD-9/ICD-10 and CPT preferred.
• Training in Medical Terminology, Anatomy and Physiology, Pathophysiology preferred.

Responsibilities

• Review provider documentation to ensure presence of all required components of the legal medical record.
• Perform a comprehensive review of outpatient and inpatient charts for documentation consistency and adequacy to identify all appropriate coding based on CMS HCC categories.
• Assist in chart review for CMS STAR quality measures reporting.
• Accurately follow ICD-10-CM coding and reporting guidelines according to AZPC policy.
• Demonstrate analytical and problem-solving ability with regard to barriers in receiving and validating accurate HCC information.
• Complete appropriate documentation/data entry to report all validated ICD-10 codes.
• Support and participate in process and quality improvement initiatives.
• Take responsibility and ownership of coding projects as assigned; work with team members to finish with speed and accuracy.
• Keep current on governmental coding and compliance issues.
• Attend seminars and in-services to remain current on coding issues.
• Share knowledge of issues with management staff.
• Other duties as assigned.

Skills

Excellent interpersonal skills

Team oriented

Analytical thinking

Education

High school diploma or equivalent

AHIMA or AAPC coding certification

2 years HCC coding experience

Medical Terminology, Anatomy & Physiology, Pathophysiology training

Tools

Microsoft Office

Job description

Arizona Priority Care (AZPC) is an Integrated Provider Network focused on providing whole-person care to Senior and Medicaid populations, through advanced value-based models. Our provider network is comprised of more than 6,000 health care providers, including primary and specialty care physicians, hospitals and ancillary providers. We have operated in the Arizona market for more than 14 years, based in Chandler, Arizona, and are an affiliate of Heritage Provider Network. As a leading value-based provider organization, we are committed to improving the quality of care, providing excellent member and provider experiences all while reducing cost.

The HCC Coder II is a highly organized, team-oriented individual who possesses the ability to quickly understand and carry out verbal and written directions and can efficiently multi-task and work on special projects in addition to regular review of outpatient and inpatient charts. The Coder II will be responsible for identifying and reporting all HCC diagnoses from outpatient and inpatient charts.

POSITION DUTIES & RESPONSIBILITIES

• Review and analyze provider documentation to ensure presence of all required components of the legal medical record.
• Perform a comprehensive review of outpatient and inpatient charts for documentation consistency and adequacy to identify all appropriate coding based on Centers for Medicare & Medicaid Services (CMS) HCC categories.
• Assist in chart review for the purpose of reporting to CMS STAR quality measures.
• Accurately follows ICD-10-CM coding and reporting guidelines according to established AZPC coding policy.
• Demonstrate analytical and problem-solving ability with regard to barriers in receiving and validating accurate HCC information.
• Complete appropriate documentation/data entry to report all validated ICD-10 codes.
• Support and participate in process and quality improvement initiatives.
• Take responsibility and ownership of coding projects as assigned. Work with other team members and ensure completion with appropriate speed and expected accuracy.
• Keeps current on all governmental medical and legal issues specific to coding and compliance.
• Attends seminars and in-services as required to remain current on coding issues.
• Responsible for sharing knowledge of issues with management staff.
• Other duties as assigned.

EDUCATION, TRAINING AND EXPERIENCE

• High school diploma or equivalent – Required.
• Current Coding Certification through AHIMA or AAPC required, one year experience using ICD-9/ICD-10 & CPT preferred.
• 2 years of experience in HCC coding required, CRC preferred.
• Completion of training in Medical Terminology, Anatomy and Physiology, Pathophysiology of Diseases preferred or other healthcare related experience.
• Excellent interpersonal skills.
• Proficiency with Microsoft Office as well as intermediate skills in Excel and Word.

*This role requires FT in-office presence for the first 60 days of employment. Hybrid schedule available after initial training period.*

Compensation range: The hourly range for this position is: $28-$32