HCC Coder

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Job Description:
Reviews medical record information to identify, collect, assess, monitor, and document claims and encounter coding information as it pertains to Hierarchical Condition Categories (HCC). Evaluates clinical documentation to determine all appropriate ICD-9-CM coding based on CMS HCC categories. Comprehension of current billing and coding regulations, policies, and procedures. Demonstrates knowledge of medical terminology, anatomy, and physiology to recognize relevant data in patient charts. Proves analytical and problem-solving expertise regarding obstacles to receiving and validating accurate HCC information. Deciphers correct HCC assignment by using expertise of coding software, coding conventions, local medical review policy, and hospital procedures.
Performs chart review to assign and sequence accurate ICD-9-CM codes for each diagnosis in accordance with coding and reimbursement guidelines.
Abstract ICD-9-CM codes from both handwritten charts and electronic medical records.
Utilize computer applications that support multiple medical plans.
Participate in process and quality improvement initiatives.
Complete appropriate documentation (paperwork and/or system entry) regarding claim and encounter information.
Working knowledge of a Medicare and its impact on reimbursement.
Ensures accurate coding by clarifying diagnosis information with physicians to obtain final diagnosis and clarify documentation when needed.
Verifies codes and charges assigned by other departments for accuracy.
Maintains patient confidentiality at all times.
Uses medical reference resources and contacts to thoroughly

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