Clinical Documentation Integrity Specialist (Coder)
New
T
TGH Senior Center Powered by Greenbrook MedicalPrimary Care
Remote within the U.S.; preference for those located in Eastern or Central time zones., Eastern or Central time zones preferred.Full-TimeMiddle
Salary$33-$36 per hour, based on experience and qualifications
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Job Details
- Experience
- 3+ years of experience in CMS-HCC risk adjustment or HCC coding; 3+ years of ICD-10 coding experience; 1+ year of HEDIS/Stars experience.
- Required Skills
- Microsoft Office
Requirements
- Professional Coder (CPC) Certification.
- 3+ years of experience in CMS-HCC risk adjustment or HCC coding.
- 3+ years of ICD-10 coding experience.
- 1+ year of HEDIS/Stars experience.
- Experience working in both prospective and concurrent workflows.
- Strong knowledge of medical terminology, anatomy, physiology, disease processes, and pharmacology.
- Proficiency with MS Office (Excel, PowerPoint, Word).
- Clear, professional communication and ability to defend coding decisions.
- Strong organization and attention to detail.
- Ability to work in a fast-paced environment.
Responsibilities
- Apply expert coding judgment using ICD-10 guidelines to validate diagnosis codes.
- Support clinical care teams through comprehensive pre-visit and post-encounter chart reviews.
- Abstract clinical information and diagnostic codes from hospital claims, radiology reports, and specialist notes.
- Analyze MRA reports to identify unreported or unresolved conditions.
- Query providers when clarification or additional documentation is needed.
- Educate clinicians on HCC coding and documentation best practices.
- Review system-generated reports to correct or complete missing data.
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