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Optum Certified Risk Adjustment Coder in Colorado Springs, Colorado

Job Summary

The Certified Risk Adjustment Coder will review and abstract healthcare encounter documentation and assign appropriate ICD-10-CM codes.

Major Responsibilities

  • Effectively and efficiently work with ICD-10-CM codes for proper billing.

  • Correctly assign ICD-10-CM codes as supported by documentation according to Optum Risk Adjustment Guidelines.

  • Provide coding review and validation of visit/chart notes.

  • Query providers regarding missing, unclear, or conflicting health record documentation.

  • Delete ICD-10-CM codes that are not supported by documentation, validate code selection, and identify suspect conditions for coding.

  • Identify suspect/unreported HCC Codes in the notes/records to reflect the severity of the patient’s condition.

  • Provide feedback query (send backs) to providers in instances of coding-related problems/issues.

  • Back-up and assist other department personnel as required.

  • Complete all coding duties as assigned on a daily basis according to daily productivity requirements.

  • Perform additional job relevant duties as needed.

Qualifications

Knowledge/Skills/Abilities:

  • Experience in Medical Risk Adjustment coding and CMS coding guidelines.

  • Versed in identifying suspect and deleted conditions.

  • Ability to meet basic productivity guidelines and accuracy percentage of at least 96%.

  • Basic computer knowledge and a typing speed of at least 30 wpm.

  • Learn and effectively use Allscripts/Touchworks electronic health record (EHR) system and coding assisting programs.

  • Work with providers and clinical staff in a courteous and pleasant manner.

  • Work with a high level of speed and accuracy over long periods of time and stress.

  • Perform in an organized and efficient manner, demonstrating adaptability and flexibility.

  • Knowledge of coding guidelines and regulations required.

  • Extensive knowledge of medical terminology.

  • Accurately abstract healthcare encounter documentation and assign appropriate healthcare codes as supported by the documentation, with a focus on ICD-10-CM codes.

Experience:

  • 3 years’ experience in ICD-10-MC coding or 2 years’ minimum experience in HCC coding required.

Education:

  • High school diploma or general education degree (GED).

  • Coding Certification from AAPC or AHIMA (CPC, RHIT, RHIA, CCS, CRC) required.

  • Associates degree preferred.

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