Summary
Certified Medical Coder role is responsible for reviewing, abstracting, and coding inpatient and/or outpatient medical records to ensure proper ICD-10-CM, HCPCS, and CPT coding and compliance with Risk Adjustment requirements.
Key Responsibilities
Follows CMS Risk Adjustment guidelines and has a complete understanding of their real-world application
Reviews submitted medical records to identify ICD-10-CM diagnoses, ensuring the documentation meets all CMS standard requirements for valid submission
Codes all diagnoses and services accurately and completely, from the medical record in accordance with the ICD-10-CM coding classification system
Selects and accurately records all appropriate records and data on assigned chart abstraction projects
Ability to meet productivity and accuracy requirements
Performs other duties as assigned
Qualifications
High School Diploma or GED required
A certification in one of the following is required:
Certified Professional Coder (CPC)
Certified Risk Adjustment Coder (CRC)
Certified Coding Specialist (CCS)
Registered Health Information Technician (RHIT)
Registered Health Information Administrator (RHIA)
Minimum of three (3) years HCC experience performing concurrent and retrospective risk adjustment chart reviews required
Current AAPC or AHIMA credential required
Risk Adjustment / HCC knowledge required
Managed Care experience preferred
Certified Medical Coder • Houston, TX, US
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