Prisma Health
Risk Adjustment Coder Professional Billing II, FT, Days, - Remote
Prisma Health, Boyce Lawn, South Carolina, United States
Inspire health. Serve with compassion. Be the difference.
Job Summary Conducts prospective review to abstract Hierarchical Condition Categories (HCC's) codes to report for the calendar year. Communicates (via Epic and in person) with providers on any outstanding HCC capture opportunities. Conducts retrospective reviews to ensure that documentation supports reporting the Hierarchical Condition Category code prior to payor submission. Essential Functions
All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference. Conducts prospective review of charts to identify HCC opportunity. Conducts retrospective review of charts to confirm documentation supports reporting. Utilizes payor specific software to assist in capturing HCCs. Communicates with providers about HCC opportunities for improvement. Identifies suspect conditions that would potentially support reporting an HCC. Participates in education offerings. Participates in monthly meetings. Performs other duties as assigned. Supervisory/Management Responsibilities Performs as a non-management job that will report to a supervisor, manager, director or executive. Minimum Requirements
Education: High School diploma or equivalent or post‑high school diploma / highest degree earned. Associate degree preferred. Experience: Five (5) years professional fee coding experience. In Lieu Of NA Required Certifications, Registrations, Licenses
Certified Professional Coder (CPC). Certified Risk Adjustment Coder (CRC). Knowledge, Skills and Abilities
Knowledge of office equipment (fax/copier). Proficient computer skills including word processing, spreadsheets, database. Data entry skills. Mathematical skills. Work Shift Day (United States of America) Location Independence Pointe Facility 7002 Value-Based Care and Network Services Department 70028459 HCC Coding Services Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.
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Job Summary Conducts prospective review to abstract Hierarchical Condition Categories (HCC's) codes to report for the calendar year. Communicates (via Epic and in person) with providers on any outstanding HCC capture opportunities. Conducts retrospective reviews to ensure that documentation supports reporting the Hierarchical Condition Category code prior to payor submission. Essential Functions
All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference. Conducts prospective review of charts to identify HCC opportunity. Conducts retrospective review of charts to confirm documentation supports reporting. Utilizes payor specific software to assist in capturing HCCs. Communicates with providers about HCC opportunities for improvement. Identifies suspect conditions that would potentially support reporting an HCC. Participates in education offerings. Participates in monthly meetings. Performs other duties as assigned. Supervisory/Management Responsibilities Performs as a non-management job that will report to a supervisor, manager, director or executive. Minimum Requirements
Education: High School diploma or equivalent or post‑high school diploma / highest degree earned. Associate degree preferred. Experience: Five (5) years professional fee coding experience. In Lieu Of NA Required Certifications, Registrations, Licenses
Certified Professional Coder (CPC). Certified Risk Adjustment Coder (CRC). Knowledge, Skills and Abilities
Knowledge of office equipment (fax/copier). Proficient computer skills including word processing, spreadsheets, database. Data entry skills. Mathematical skills. Work Shift Day (United States of America) Location Independence Pointe Facility 7002 Value-Based Care and Network Services Department 70028459 HCC Coding Services Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.
#J-18808-Ljbffr