Inspire health. Serve with compassion. Be the difference.
Job Summary
Conducts prospective review to abstract Hierarchical Condition Categories (HCC's) codes to report for the calendar year. Communicates (via Epic and in person) with providers on any outstanding HCC capture opportunities. Conducts retrospective reviews to ensure that documentation supports reporting the Hierarchical Condition Category code prior to payor submission.Essential Functions
All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference.
Conducts prospective review of charts to identify HCC opportunity.
Conducts retrospective review of charts to confirm documentation supports reporting.
Utilizes payor specific software to assist in capturing HCCs.
Communicates with providers about HCC opportunities for improvement.
Identifies suspect conditions that would potentially support reporting an HCC.
Participates in education offerings
Participates in monthly meetings
Performs other duties as assigned.
Supervisory/Management Responsibilities
This is a non-management job that will report to a supervisor, manager, director or executive.
Minimum Requirements
Education - High School diploma or equivalent or post-high school diploma / highest degree earned. Associate degree preferred
Experience - Five (5) years professional fee coding experience
In Lieu Of
NA
Required Certifications, Registrations, Licenses
Certified Professional Coder (CPC), and
Certified Risk Adjustment Coder(CRC)
Knowledge, Skills and Abilities
Knowledge of office equipment (fax/copier)
Proficient computer skills including word processing, spreadsheets, database
Data entry skills
Mathematical skills
Work Shift
Day (United States of America)Location
Patewood Memorial HospitalFacility
7002 Value-Based Care and Network ServicesDepartment
70028459 HCC Coding ServicesShare your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.
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