CMS-HCC Risk Adjustment

Department
Risk adjustment
Job posted on
28/03/2024
Experience range
3 Years
Work Mode
Remote

Job description

Concurrent CMS-HCC Risk Adjustment Project  GeBBS is currently accepting applications for final HCC Coding reviewers for Medicare and Medicare Advantage Plans in an ongoing CMS-HCC coding project.  This is an employee status (W-2) position.   Must have a minimum of 3 full years active HCC coding experience post certification.

  • Current CPC, CCS, RHIT, or RHIA or equivalent through the AAPC or AHIMA required – CRC preferred, but not required.
  • Must have at least 3 years of active HCC coding experience post credential.
  • Must have at least 3 years of ICD-10 coding experience.
  • Experience coding both IP and OP charts.
  • Candidates will be required to pass a risk adjustment coding test.
  • Must pass background check and a drug screening exclusive of THC.
  • Coders be able to maintain a 95% accuracy rate – US Based candidates only.
  • Concurrent review coding for CMS-HCC 
  • Must comply with accepted coding practices as defined in the ICD-10-CM, AHA Coding Clinic, and Client Coding Guidelines
  • Coder will review, verify, reorder and add/remove dx codes as needed.
  • Medicare Plans In a concurrent coding review process, coders review the EHR/medical notes and HCC codes in real time before the claims are submitted to payers.
  • This process helps ensure the diagnosis coding accurately supports what the physician documented in the EMR.  In many cases, the physician will perform robust clinical documentation, but may not select the most appropriate ICD-10 code.  Having the medical coding team perform this concurrent review prior to claim submission achieves two benefits: First, it ensures the physician’s hard work in delivering and documenting care is correctly translated into accurate HCC codes. Secondly, it ensures the payers have the correct HCC codes on the initial claim, eliminating the need for an additional retrospective review.

Get in touch with GeBBS and enhance your financial outcome