AAPC

Medical Billing and Coding

• Code medical records to validate ICD-10-CM codes for PACE Risk Adjustment
• Meet department production and quality standards
• Research regulatory guidelines for supporting documentation
• Prepare coding reports using excel
• Prepare oral and/or written reports of work activity to Supervisor
• Be responsible and accountable for maintaining the confidentiality, integrity, and availability of protected health information.
• Follow HIPAA security policies and procedures affecting your job, and report any suspected or actual violation or breach
• Other duties as assigned

Risk Adjustment Coder

Auditor

• Oversee the management of multiple projects
• Manage client needs and expectations to ensure projects meet scope, requirements and deliverables are on-time and of high quality
• Perform production work in addition to project management, meeting department’s quality and production standard thresholds
• Responsible for maintaining department audit standards, clinical documentation standards, protocols and guidelines
• Review auditor work for accuracy and provide feedback written and verbally to auditors
• Audit medical records to validate clinical documentation to support evaluation and management services, ancillary services, procedures, and diagnoses and meet department quality and production standards
• Research regulatory guidelines for supporting documentation
• Prepare audit summary findings, providing detailed comments related to the audit findings and make recommendations
• Support team with department key performance indicators and goals (SLAs)
• Embrace workforce transformation by engaging in continuous knowledge expansion across additional functional areas and/or upskilling (learning new skills) to support evolving organizational and client needs
• Contribute to organizational optimization by collaborating to identify opportunities for process improvement and supporting continuous enhancements to workflows and operations that promote quality and efficiency
• Prepares oral and/or written reports of client and audit activity for Manager, meeting with them on a regular basis to review individual performance, mentoring, and succession planning

Risk Adjustment Coder

Senior Auditor – Project Lead