Job Description
ESSENTIAL DUTIES AND RESPONSIBILITIES
Operations
Review medical records to identify appropriate codes according to HCC, CPT, and ICD-10 models. Verify and ensure the accuracy and completeness of codes. Review and provide feedback on documentation and codes submitted by providers, colleagues, external stakeholders, or from EHR systems.
Monitoring
Performs coding quality reviews in accordance with Conifer applicable monitoring policies of achieving 95% accuracy or higher.
Conducts chart audits to identify additional codes (ICD-10 or procedure, CPT-4, CPT II, HCPCS, etc). Organizes and reviews charts for coding audits and prepares action plans in response to audit findings.
Maintaining Stakeholder Relationships
Responds to inquiries from health plans and providers. Oversees data submissions to client, vendors, and internal stakeholders. Conducts trainings and outreach to provider offices.
Professional Development
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