HCC Risk Coding Lead — Chart Reviews & Education

Essen Health Care; New York (NY); On-site; USD 71,635,000 - 82,656,000; Full time

Benefits offered by this job

Bonuses

OT available

Full-time employment

Job summary

Essen Health Care is seeking a risk coding specialist to implement CMS-HCC guidelines and ensure accurate documentation of disease burden across 50+ locations in New York. The role involves reviewing charts, identifying suspect conditions, and designing workflows to alert providers for thorough documentation.

Ideal candidates will have CRC or CPC/CCS/RHIT/RHIA credentials, familiarity with ICD-10-CM, and experience with coaching providers and coordinating offshore teams to improve coding quality.

Qualifications

• Strong working knowledge of CMS-HCC risk adjustment and ICD-10-CM guidelines.
• Ability to accurately identify and code chronic conditions requiring annual recapture.
• Experience with chart reviews and documentation improvement initiatives.

Responsibilities

• Oversee an offshore team in conducting risk coding activities.
• Conduct chart reviews to identify suspect conditions and highlight inadequately coded progress notes.
• Design workflows to notify doctors of suspect conditions and ensure relevant results are reviewed.
• Educate providers on proper documentation and coding guidelines.
• Suggest improvements to team workflows to maximize coding integrity.

Skills

CMS-HCC risk adjustment

ICD-10-CM coding

Chronic condition coding

Chart reviews

Provider education

Documentation improvement

Excel

KPIs reporting

Offshore team coordination

Education

High School Diploma or equivalent

International Medical Graduate

CRC

CPC/CCS/RHIT/RHIA

Job description

Essen Health Care is seeking a risk coding specialist to implement CMS-HCC guidelines and ensure accurate documentation of disease burden across 50+ locations in New York. The role involves reviewing charts, identifying suspect conditions, and designing workflows to alert providers for thorough documentation.

Ideal candidates will have CRC or CPC/CCS/RHIT/RHIA credentials, familiarity with ICD-10-CM, and experience with coaching providers and coordinating offshore teams to improve coding quality.