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About the Role
**Description**
Under the supervision of the Quality Integrity program, Manager, the HCC Coding Quality Auditor is responsible for detailed diagnostic chart reviews of clinical documentation and coding associated with Risk Adjustment and HCC coding. The incumbent reviews and abstracts HCC codes to ensure they are coded accurately, to the highest specificity, queries providers to clinically validate or clarify diagnosis criteria, and reviews for compliant documentation resulting in compliant reporting/billing and RVU capture. Serves as a coding expert, working with the Quality Integrity Program manager and clinical documentation review team to ensure compliance with Official Coding Guidelines for Coding and Reporting, coding conventions and regulatory oversight agencies. This includes the identification and researching of provider diagnostic coding concerns, documentation compliance standards, and performing education related to provider coding errors. The incumbent s...
Under the supervision of the Quality Integrity program, Manager, the HCC Coding Quality Auditor is responsible for detailed diagnostic chart reviews of clinical documentation and coding associated with Risk Adjustment and HCC coding. The incumbent reviews and abstracts HCC codes to ensure they are coded accurately, to the highest specificity, queries providers to clinically validate or clarify diagnosis criteria, and reviews for compliant documentation resulting in compliant reporting/billing and RVU capture. Serves as a coding expert, working with the Quality Integrity Program manager and clinical documentation review team to ensure compliance with Official Coding Guidelines for Coding and Reporting, coding conventions and regulatory oversight agencies. This includes the identification and researching of provider diagnostic coding concerns, documentation compliance standards, and performing education related to provider coding errors. The incumbent s...
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