Responsible for evaluating the accuracy and consistency of coded clinical data quality results and reports in accordance with accepted and established standards.Collaborate with the Billing Manager and Medical Director in providing expertise in using and applying current coding classifications including but not limited to ICD-10-CM, CPT, E&M, and record documentation to ensure compliance in the collection of outpatient diagnoses and services.Identify, collect, assess, monitor, and document claims and encounter coding information as it pertains to Clinical Condition Categories.Verify and ensure the accuracy, completeness, specificity, and appropriateness of diagnosis codes based on services rendered.Review medical record information to identify all appropriate coding based on CMS HCC categories.Complete appropriate paperwork/documentation/system entry regarding claim/encounter information.Perform coding and abstracting with an accuracy rate higher than 95%.Provide support, education, and training related to documentation quality, level of service, and diagnosis coding consistent with established coding guidelines and standards.Monitor coding changes to ensure that the most current information is available.Demonstrate analytical and problem-solving ability regarding barriers to receiving and validating accurate HCC information.

Gained comfort with medical charts and computer applications used in researching information for medical charts.Gained a better understanding of medical terminology used in medical charts and how to ensure accurate information.

Gained proficiency in locating, coding, and refiling inpatient, outpatient, emergency, and surgery department medical charts.Furthered comfort level with chart interfacing and operating under Chilton Medical Center’s specific policy guidelines.