Roles and Responsibilities:

1) Manage the program for high-quality, timely coding of diagnoses and procedures for inpatient and outpatient accounts, using ICD-10 and CPT-4 coding classification systems, to meet billing system requirements

2) Reviews submitted medical records to identify ICD-10-CM diagnoses, that map to a Risk Adjusted HCC and ensuring the documentation meets all CMS standard requirements for valid HCC Submission

3) Accounts for coding and abstracting of patient encounters, including diagnostic and procedural information, significant reportable elements, and complications.

4) Audits clinical documentation and coded data to validate documentation

5) Identifies discrepancies, potential quality of care, and billing issues.

6) Assigns codes for reimbursements, research and compliance with regulatory requirements utilizing guidelines.

7) Adhering to the company requirements as per special projects

Pre-requisites :

1) Graduation (must) with minimum 1-year experience in Medical Coding.

2) Experience in HCC Coding, ICD-10-CM, CPT is mandatory.

3) Good understanding of medical terminology, anatomy, and physiology.

4) Excellent written and verbal communication skills.

5) Quick learner, adaptable to changing business needs, proactive & self-motivated individual with effective time management & multitasking skills.

Good to Have :

1) CPC Certification for medical coding is a strong plus.

2) Experience in the US Healthcare medical coding domain.

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