Risk Adjustment Certified Coder

University Physicians' Association; Knoxville (TN); Remote; USD 40,000 - 60,000; Full time

Job summary

A healthcare provider in Knoxville is seeking a full-time Certified Medical Coder. The position requires thorough clinical documentation reviews and accurate coding of HCC diagnoses using ICD-10-CM guidelines. Candidates must have current CPC or RHIT certification, be team players with strong communication skills, and maintain HIPAA privacy. This remote role involves occasional onsite meetings, making it crucial for candidates to reside in the Knoxville area.

Qualifications

• Must have effective written and verbal communication skills.
• At least two years of experience in E/M and professional medical coding preferred.
• Proficiency in Microsoft Office tools is necessary.

Responsibilities

• Perform coding services while meeting daily production and quality goals.
• Conduct thorough reviews of clinical documentation for accuracy.
• Educate and coach providers on compliant coding practices.

Skills

CPC certification

RHIT certification

HCC coding experience

Communication skills

Problem solving

Attention to detail

Education

Current CPC or RHIT certification

CRC within 6 months of hire

Tools

Microsoft Outlook

Excel

Word

PowerPoint

Job description

This position requires normal business hours Monday-Friday. This is a remote position with occasional on-site meetings. Candidate must be able to maintain HIPAA privacy requirements when working from home. Candidate must be located in the Knoxville, TN region.

University Health Network is seeking a full-time Certified Medical Coder to join our team. This role involves performing detailed clinical documentation and risk adjustment reviews and accurately coding HCC diagnoses using ICD-10-CM guidelines. CPT and E/M experience is not required for this role.

Essential Duties and Responsibilities (this list does not include all duties assigned)

Performs coding services while meeting daily production and quality goals

• Conduct thorough reviews of clinical documentation to ensure accuracy and compliance with coding standards.
• Assign appropriate ICD-10-CM, CPT, HCPCS, and modifiers for professional services.
• Collaborate with healthcare providers to clarify diagnoses and procedures to ensure accurate coding.
• Use CMS and HHS risk adjustment mapping tools to identify HCC coding and documentation opportunities
• Participate in ongoing education and training to stay current with coding updates and guidelines
• Actively participates in designated team meetings
• Consistently meets coding productivity and accuracy standards while managing different responsibilities and workflows. If unable to maintain productivity and accuracy standards, team members will work onsite at the UHN office until standards are met and maintained.

Partners with providers, practice staff, and UHN Coding team to improve quality and efficiencies in coding and documentation

• Educates and coaches providers on compliant coding and documentation practices
• Facilitates and supports a culture of compliance, ethics, and integrity
• Recognized as an expert in medical coding, documentation, and risk adjustment compliance
• Interacts effectively and builds respectful working relationships across the organization.

Maintains HIPPA Guidelines for privacy

• Respects the privacy of all patients 100% of the time
• Understands and abides by HIPAA laws and regulations and UPA HIPAA policy at all times
• Obtains consent to release protected health information
• Reports all HIPAA issues to the Supervisor

Remains current on coding rules and guidelines

• Remains up to date with official AMA ICD-10-CM, CPT, and HCPCS coding guidelines and regulations, Medicare, other MA and commercial plans, and internal guidelines
• Remains up to date with CMS and HHS HCC risk adjustment models
• Meets CEU requirements and remains in good standing with AAPC/AHIMA certifications

Requirements

• Current CPC or RHIT certification required.
• CRC required within 6 months of hire
• Preferred at least two years of E/M and professional medical coding experience in an ambulatory care setting.
• Preferred experience and knowledge of HCC coding, knowledge related to chronic illness diagnosis, treatment, and management
• Must be a team player with effective written and verbal communication, relationship-building, and interpersonal skills
• Must be initiative-taking, highly organized, and have excellent time management
• Must possess good problem solving and critical thinking skills
• Exceptional attention to detail and proficiency in Microsoft Outlook (Outlook, Word, Excel, and PowerPoint)
• Demonstrates integrity by adhering to high standards of personal and professional conduct