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Virtix Health logo
Virtix Health

Innovative technology solutions for health plans, supporting Medicare Advantage, ACA, Medicaid & HEDIS

HCC Coding Quality Specialist – Auditor

Location

United States

Posted

64 days ago

Salary

0

Seniority

Senior

Professional Certificate5 yrs expEnglish

Job Description

HCC Coding Quality Specialist – Auditor

Virtix Health

• HCC Coding Quality Specialist Team Members will be responsible for reviewing the accuracy of our HCC coded records, specifically those that map to HCCs and RxHCCs. • Auditors will support their findings utilizing Medicare guidelines, ICD-10-CM guidelines as well as client specific requirements. • Ensure that the codes captured are supported by the documentation within the record and are properly coded following Medicare guidelines, ICD-10-CM guidelines as well as client specific guidelines for the project. • Support your findings in a way the coder can easily identify and learn from the error. • Have strong and professional communication skills. • Be a resource for HCC coding team members by having a deep understanding of the project and coding guidelines. • Follow Risk Adjustment Data Abstraction Rules. • Assist with the creation of PowerPoints presentations for training purposes. • Will be required to maintain a quality score of 95% or higher. • Will be required to maintain an ongoing productivity level based on project requirements.

Job Requirements

  • All auditors MUST be certified through either the AAPC or AHIMA. (Apprenticeship designations are not accepted.)
  • Acceptable credentials would be CPC, CRC, CCS, or CCS-P.
  • Must have at least 3 years of HCC coding experience with 2 years of auditing experience.
  • Global experience preferred.
  • Must have working knowledge and experience with systems such as EMRs, Billing systems, abstraction platforms, etc.

Benefits

  • Accrued PTO
  • Paid Holidays
  • Medical/Dental/Vision Insurance
  • 401k
  • CEUs and more!

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