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UASI · 8 hours ago

HCC Coding Auditor

United States

Full-time

Remote

Entry, Mid Level

2+ years exp

UASI is seeking several experienced HCC Auditors to join our Quality Management team to execute quality review processes for staff providing prospective, concurrent, and retrospective HCC reviews, as well as HEDIS measures. The role involves performing quality reviews, providing training and mentoring to staff, and enhancing the overall quality of coders through education.

Hospital & Health Care

Culture & Values

Responsibilities

Utilize risk adjustment coding/HCC and HEDIS expertise to perform quality reviews on internal/subcontracted HCC coders/OP CDI

Use audit tool to analyze quality results and track overall quality

Provide necessary feedback and research to HCC Coder/ OP CDI in response to coding and documentation questions

Ability to assess queries for compliance and appropriate composition based on the AHIMA Query Practice Brief

Prepare and deliver training on HCC documentation requirements, customized to the client audience (e.g., providers, HCC coders)

Assess HCC coders/OP CDI chart reviews for missed documentation or query opportunities impacting RAF scores/HEDIS measures

Review charts to assure clinical documentation supports MEAT requirements and identify trends in documentation gaps

Provide education to HCC Coders/OP CDI as needed based on audit findings

Identify trends and perform training to improve HCC capture, HEDIS measure review, and quality

Work with Manager to identify performance needs of Coders/OP CDI and create training to increase performance levels

Qualification

HCC coding expertiseHEDIS measures knowledgeCCSCRC certificationICD-10-CM knowledgeCPT/HCPCS coding knowledgeMicrosoft Office proficiencyRNRHIA degreeOffshore teamsAuditing experience

Required

Coding credential of CCS or CRC required

2-5 years of experience in auditing HCCs (prospective & retrospective) or outpatient CDI

Experience with Microsoft Office including 365, Word, Excel, PowerPoint

3 years of experience in auditing an ambulatory clinic setting, with knowledge of ICD-10-CM, HCC and CPT/HCPCS coding requirements, as well as OP CDI and HEDIS measures