Risk Adjustment Coder/ Auditor (Data Validation)

Responsibilities:

• Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10-CM codes are accurately assigned and supported by clinical documentation.
• Primarily for QHP (RADV)
• Ability to code government and state models.
• This includes code everything projects.
• Maintain current knowledge of ICD-10-CM codes, CMS documentation requirements, and state and federal regulations.
• Ability to maintain a 95% accuracy rate on all coding projects.
• Coders assist with code abstraction and coding quality audits using the Official Coding
• Guidelines for ICD-9-CM/ICD-10-CM, AHA Coding Clinic Guidance, and in accordance with all state regulations, federal regulations, internal policies, and procedures.