RiskAdjustmentCoder

**POSITION SUMMARY:** The Risk Adjustment Coder determines the appropriate ICD10-CM diagnoses codes based on clinical documentation that follows the Official Guidelines for Coding and Reporting and Risk Adjustment guidelines for risk adjustment and Hierarchical Condition Categories (HCC). Risk adjustment coding relies on ICD-10-CM coding to assign risk scores to patients. The incumbent reviews retrospective medical record documentation and ensures that the codes are appropriately assigned. The outcome will be documentation that accurately and completely captures the clinical picture/severity of illness/complexity of the patient while providing specific and complete information to be utilized in coding, profiling and outcomes reporting of both the facility and the physicians. The Risk Adjustment Coder utilizes standards of compliance, specifically in OP compliant query processes and clinical knowledge to identify opportunities and to achieve results Also required is advanced knowledge of CPT, ICD-10-CM, and HCPCS coding systems. **Position:** Risk Adjustment Coder **** **Department:** Clinical Documentation **Schedule:** Full Time **ESSENTIAL RESPONSIBILITIES / DUTIES:** * Review documentation available in the Medical Record to facilitate workflows that support the clinical picture/severity of illness/complexity of the patient care rendered to patients. * Reviews medical records to ensure accurate codes are applied to the encounter. * Utilize available encoder, grouper software, and other coding resources to determine the appropriate ICD-10-CM diagnosis codes mapped to HCCs or other RA methodologies * Actively participate in and maintain coding quality and productivity processes * Collaborates with nursing or coding staff on retrospective medical record review for severity, accuracy, and quality issues. * Ensure documentation in the medical record follows the official coding guidelines, internal guidelines and the * AHIMA/ACDIS physician query brief. * Create and ana