Job description

Overview:CMS-HCC Risk Validation Audit (RADV/IVA)
GeBBS Healthcare Solutions, an industry leader in Health Information Management and Revenue Cycle Management, is seeking highly motivated individuals with a passion for excellence and collaboration, for careers in the healthcare industry. Join this exciting team working remotely in a flexible CMS HCC/Risk Adjustment role for a minimum of 20 hours weekly.
Responsibilities:

• Primary Reviews

• Coders will also review member and claim data validation aspects, which include: Member name, Member DOB, Gender, Dates of service, claim type, and provider signature.
• Coders will be presented with all risk-adjusting diagnoses billed on a claim for a particular date of service or inpatient stay
• Must be able to identify CPT codes to match visit to selected encounter.
• Must be able to identify acceptable provider specialty.
• Coder must have knowledge of ICD-10-CM IP and OP coding.
• Coders will confirm or not confirm each diagnosis
• Coders will add risk-adjusting diagnoses that are valid but not reported
• Coders will be required to select a rationale for the strength of the supporting documentation for each risk-adjusting diagnosis:

• Strong
• Medium
• Weak
• Not supported

• Expected Primary CPH: 2-3 CPH

• Senior Review

• Same as primary review, but doing review on records already primarily reviewed
• Provide educational feedback to the Primary coding team.
• Recommend chart restriction on coders that aren’t meeting quality expectations.
• Recommend primary coders that are ready to move to a senior role.
• Expected Senior CPH: 3-4 CPH

Qualifications:

• This is a W2 position for a long term project
• Active certification through AAPC or AHIMA is required
• 5 years coding experience post certification and must provide proof (senior reviewer)
• 3 years coding experience post certification and must provide proof (primary reviewer)
• 3 years risk adjustment experience preferred both senior and primary
• Must be able to maintain a 95% accuracy rate
• Great attention to detail is a must!
• Hybrid pay scale based on production
• US-Based Candidates Only

Job Types: Full-time, Part-time

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