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CMS-HCC Risk Validation Audit (RADV/IVA) - Part Time

Overview:

CMS-HCC Risk Validation Audit (RADV/IVA) - Part Time

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
- Strong
- Medium
- Weak
- Not supported

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 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:
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: 3.5 CPH

Qualifications:

This is a W2 position for a long term project
Active certification through AAPC or AHIMA is required
5 years risk adjustment coding experience and must provide proof
Must be able to maintain a 95% accuracy rate
Hybrid pay scale based on production
US-Based Candidates Only

GeBBS Healthcare Solutions Glassdoor Company Review

4.4

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CEO of GeBBS Healthcare Solutions

Milind Godbole

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By GeBBS Healthcare Solutions

Partnering with clients to help them achieve their strategic business objectives by deploying business impacting solutions with passion, excellence and speed of execution.

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INDUSTRY

Health Care Services & Hospitals

TEAM SIZE

10000+

LOCATION

Hybrid, based in Los Angeles, India

DATE POSTED

August 6, 2023