HCC Coding Auditor

UASI is seeking several experienced HCC Auditors to join our Quality Management team to execute quality review processes for staff providing prospective, concurrent, and retrospective HCC reviews, as well as HEDIS measures, to identify and provide training and mentoring to staff, increase the overall quality of Coders through education.

Responsibilities:

• Utilize risk adjustment coding/HCC and HEDIS expertise to perform quality reviews on internal/subcontracted HCC coders/OP CDI.

• Use audit tool to analyze quality results and track overall quality.

• Provide necessary feedback and research to HCC Coder/ OP CDI in response to coding and documentation questions.

• Ability to assess queries for compliance and appropriate composition based on the AHIMA Query Practice Brief

• Prepare and deliver training on HCC documentation requirements, customized to the client audience (e.g., providers, HCC coders)

• Assess HCC coders/OP CDI chart reviews for missed documentation or query opportunities impacting RAF scores/HEDIS measures

• Review charts to assure clinical documentation supports MEAT requirements and identify trends in documentation gaps

• Provide education to HCC Coders/OP CDI as needed based on audit findings.

• Identify trends and perform training to improve HCC capture, HEDIS measure review, and quality.

• Work with Manager to identify performance needs of Coders/OP CDI and create training to increase performance levels.

Qualifications

• RN required

• Coding credential of CCS or CRC preferred

• 2-5 years of experience in auditing HCCs (prospective & retrospective) or outpatient CDI

• Experience with Microsoft Office including 365, Word, Excel, PowerPoint

• Experience working with offshore teams, preferred

• 3 years of experience in auditing an ambulatory clinic setting, with knowledge of ICD-10-CM, HCC and CPT/HCPCS coding requirements, as well as OP CDI and HEDIS measures

UASI provides a supportive environment that encourages professional development and enables each employee to achieve their individual goals. We offer a competitive pay and excellent benefit package.