[Hiring] Risk Adjustment Certified Coder @ University Physicians' Association

Role Description

This position requires normal business hours Monday-Friday. This is a remote position with occasional on-site meetings. Candidate must be able to maintain HIPAA privacy requirements when working from home. Candidate must be located in the Knoxville, TN region.

University Health Network is seeking a full-time Certified Medical Coder to join our team. This role involves performing detailed clinical documentation and risk adjustment reviews and accurately coding HCC diagnoses using ICD-10-CM guidelines. CPT and E/M experience is not required for this role.

Essential Duties and Responsibilities

• Performs coding services while meeting daily production and quality goals.
• Conduct thorough reviews of clinical documentation to ensure accuracy and compliance with coding standards.
• Assign appropriate ICD-10-CM, CPT, HCPCS, and modifiers for professional services.
• Collaborate with healthcare providers to clarify diagnoses and procedures to ensure accurate coding.
• Use CMS and HHS risk adjustment mapping tools to identify HCC coding and documentation opportunities.
• Participate in ongoing education and training to stay current with coding updates and guidelines.
• Actively participates in designated team meetings.
• Consistently meets coding productivity and accuracy standards while managing different responsibilities and workflows.
• Partners with providers, practice staff, and UHN Coding team to improve quality and efficiencies in coding and documentation.
• Educates and coaches providers on compliant coding and documentation practices.
• Facilitates and supports a culture of compliance, ethics, and integrity.
• Recognized as an expert in medical coding, documentation, and risk adjustment compliance.
• Interacts effectively and builds respectful working relationships across the organization.
• Maintains HIPAA Guidelines for privacy.
• Respects the privacy of all patients 100% of the time.
• Understands and abides by HIPAA laws and regulations and UPA HIPAA policy at all times.
• Obtains consent to release protected health information.
• Reports all HIPAA issues to the Supervisor.
• Remains current on coding rules and guidelines.
• Remains up to date with official AMA ICD-10-CM, CPT, and HCPCS coding guidelines and regulations, Medicare, other MA and commercial plans, and internal guidelines.
• Remains up to date with CMS and HHS HCC risk adjustment models.
• Meets CEU requirements and remains in good standing with AAPC/AHIMA certifications.

Qualifications

• Current CPC or RHIT certification required.
• CRC required within 6 months of hire.
• Preferred at least two years of E/M and professional medical coding experience in an ambulatory care setting.
• Preferred experience and knowledge of HCC coding, knowledge related to chronic illness diagnosis, treatment, and management.
• Must be a team player with effective written and verbal communication, relationship-building, and interpersonal skills.
• Must be initiative-taking, highly organized, and have excellent time management.
• Must possess good problem solving and critical thinking skills.
• Exceptional attention to detail and proficiency in Microsoft Outlook (Outlook, Word, Excel, and PowerPoint).
• Demonstrates integrity by adhering to high standards of personal and professional conduct.