**Combination of remote days and 2 days a month onsite Ventura ,CA **

Under general supervision, performs a prospective HCC coding, researching and extracting potential chronic conditions from physician records, hospital records, laboratory and radiology records for Primary Care Physicians to review, treat and report. Performs a retrospective review, read and analyze physicians’ notes to assess them for documentation accuracy. Development of documentation examples to aid physicians. Identify trends where clinical documentation improvement areas and areas of opportunities. Provides provider education. Assess and recommend provider performance report cards and training to support efforts to optimize efficiencies and continuous process improvements.

The Risk Adjustment Coder is responsible for the following:

• Comply with organization’s policies and capable of following directions.
• Prioritize tasks, collaborative work environment.
• Performs an ongoing prospective and retrospective chart reviews.
• Analyzes and deciphers clinical linguistics and medical terminologies to assign appropriate ICD-10 CM does.
• Perform chart audits.
• Identify trends in area of clinical documentation inconsistency, insufficiency and discrepancy.
• Build a trustful rapport with providers.
• Effectively communicate clarifications with providers through task query.
• Provider education on clinical documentation improvement efforts.
• Attention to details impacts accuracy in data validation and quality data analysis.
• Development of hierarchical condition category (HCC) tools and resource materials utilizing scientific evidenced-base medicine.
• Compliance with CMS, OIG, The Joint Commission, and other government regulations and guidelines
• Audits daily encounters to ensure clinical documentations are clear, consistent, concise and completed supported with the monitoring, evaluate, assessment and treatment (M.E.A.T.) or treatment, assessment, monitoring or medicate, plan, evaluate, and referral (T.A.M.P.E.R.™) components and data validation prior to claim submission.
• Track HCC data validation.
• Collaborate with multidisciplinary teams.
• Quantitative analysis data-driven by HCC ICD-10 CM and HCC category count.
• Quality analysis data-driven by HCC validation statuses where areas of improvements and opportunities can be identified.
• Ad Hoc Review.
• Streamlining workflow processes and collaboration with multidisciplinary teams.
• Other duties and tasks as assigned to identify continuous process improvement workflows.