HVC Coding Specialist

JOB SUMMARY:

The HVC Coding Specialist determines the appropriate ICD-10-CM diagnosis codes based on clinical documentation that follows the Official Guidelines for Coding and Reporting and Risk Adjustment guidelines. The HVC Coding Specialist reviews retrospective medical record documentation and ensures that the codes are appropriately assigned. The outcome will be documentation that accurately and completely captures the clinical picture/severity of illness/complexity of the patient while providing specific and complete information. The HVC Coding Specialist utilizes standards of compliance, specifically in outpatient compliant query processes and clinical knowledge, to identify opportunities and achieve results. This includes selecting the most specific ICD-10-CM code based on the provider documentation. Maintains accurate records of review activities to comply with departmental and regulatory agency guidelines, Understands and complies with policies and procedures related to confidentiality of medical records. Identifies opportunities for intradepartmental and interdepartmental operational improvement. Participates in program related meetings, education, staff development, departmental activities, and in-service opportunities.

EDUCATION:

High school diploma or equivalent required. College degree preferred. Anatomy and physiology and/or medical terminology required. An equivalent combination of education and experience may be considered. CPC certification by AAPC is required. CRC certification by AAPC will be required within 2 years, 1 year preferred.

EXPERIENCE:

1+ years' experience with data entry, CPT and ICD coding, health information management, and/or medical terminology required. Familiarity with Federal medical billing statutes is required. Familiarity with risk adjustment coding is preferred. Must be able to demonstrate mastery of coding through chart review. Must maintain CPC Certification and CEUs. Lapse of certification status may result in separation of employment. Recertification is at expense of employee.