About this role
Responsible for accurately transposing and reconciling clinical documentation from the EMR into the payer specific systems to provide information for proper risk adjustment of patients and increase revenue to the health plans and internal organization. This position necessitates a strong understanding of progress note components, the ability to recognize medical conditions and medications, and their relevance to specific diagnoses. The specialist provides valuable feedback to management for provider education and correction purposes, ensuring that patient records are complete and compliant with payer guidelines in a timely matter. Provides feedback to management for provider education and correction purposes. Ensures that the patient records are complete in a timely manner according to the payer specific guidelines. Must be ICD-10 proficient.
Education Associate's Degree Required or Combination of relevant education and experience may be considered in lieu of degree Required
Experience 3 years experience in clinical documentation, billing and coding, or health information management Required
Licenses Certified Professional Coder Preferred Cert Profess Medical Auditor Preferred Cert Risk Adjustment Coder Preferred