HCC Coding Specialist

This role involves reviewing neurology, behavioral health, and psychiatry patient medical records, including physician notes, hospital records, and clinical documentation. The specialist will accurately assign ICD-10-CM codes based on documentation, following HCC coding and CMS risk adjustment guidelines. They will also identify documentation deficiencies impacting HCC assignment and collaborate with providers to improve specificity. Ensuring compliance with coding standards, payer requirements, and organizational policies is crucial. Participation in coding audits and quality reviews, along with collaboration with CDI specialists and revenue cycle teams, is expected to optimize documentation and coding processes. Staying current on updates to coding rules, HCC guidelines, and mental/neurological health regulations is also a key part of the role.