Hcc Risk Adustment Coder

2 months ago

Greater Noida, India Premier Medical Associates (PMA) Full time

Duties:
Reporting to the Director of MRA and Risk Coding. the **HCC / MRA Coder** will offer real-time support and coordination for Primary Care Providers and Care Coordinators for MRA Risk Coding, HEDIS, and STARS.

Collaborates: Engages others by gathering multiple views and being open to diverse perspectives, focusing on a shared purpose that puts Asaar Medical's overall success first.

Review patient charts and pursues excellence: Seeks out learning, strives to develop and expand personally, and continuously helps others upgrade their capability to contribute to the managed care plan.
- Helps to educate clinician and non-clinician office staff on coding guidelines, documentation standards, and appropriate Medicare Risk Adjustment (MRA) procedures.
- Assists in education and transition with onboarding new providers, optimally within their first month.
- Reviews diagnoses and patient charts to identify trends and point out potentially missed chronic conditions to providers.
- Collaborates with Learning and Development when changes are necessary.
- Sets up and conducts 1:1 meeting with market providers

**Assists during health plan and Compliance audits as needed. Conducts quarterly audits of providers with high eMRA and meets with them frequently to achieve improvement.**
- Works with internal EMR to recommend accuracy in documentation and diagnoses.
- Works closely with clinical and HRDD (High Risk Disease Detection) leadership to make sure coding standards are met and there is maximization of appropriate and accurate coding, as well as prevention of inappropriate coding.
- Works with data teams to identify any potential gaps related to Risk Adjustment.
- Collaborates with technology team to improve electronic documentation of all clinical conditions during encounters.
- Stays abreast of CMS updated requirements and notifies IT so that dashboard can reflect the changes

**Auditing appropriate capture and billing of HCC codes to simulate Risk Adjustment Data Validation audits.**
- Teams with health plan MRA departments as needed to ensure appropriate acceptance of encounter data and accuracy of submissions.
- Collaborates with Operations Directors, Market Chief Medical Officers and Network Directors to identify areas of opportunity

**Job Types**: Full-time, Permanent

Pay: ₹40,000.00 - ₹70,000.00 per month

**Benefits**:

- Health insurance

Schedule:

- Monday to Friday
- Weekend availability

Work Location: In person

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