Remote Risk Adjustment Auditor Jobs in Memphis, TN

Altegra Health is a total solutions partner for healthcare data auditing and analytics. Altegra provides end-to-end solutions to help improve payment integrity data, to support accreditation programs, and to meet regulatory requirements. Altegra's nationwide network of registered nurses and certified coders professionally acquire, audit, and analyze healthcare data for healthcare organizations. Altegra Health specializes in:

1. CMS HCC Risk Adjustment

2. HEDIS

3. Medical Record Reviews (Accreditation)

4. And more

These are a remote/home based temporary positions forecast to run through the end of 2015 and Coders will be paid by the chart. Remote Certified Coders review medical records and apply appropriate ICD-9-CM diagnostic codes and Altegra Health Flagged Event. Codes must meet Altegra Health QA standards (following both Official Coding Guidelines and Risk Adjustment Guidelines).

Responsibilities:  

Abstract pertinent information from patient medical records. Assign appropriate ICD-9-CM codes, creating HCC and/or RxHCC group assignments as applicable.

Assign Altegra Health Flagged Event codes when documentation in the record is inadequate, ambiguous, or otherwise unclear for medical coding purposes.

Remain current on medical coding guidelines and reimbursement reporting requirements.

Check chart assignments every day and report accurately all hours worked on a weekly basis.

Report work-related concerns to assigned Coder Advocate and if not adequately addressed to Sr. Manager of Clinical Operations. 

Comply with the Standards of Ethical Coding as set forth by the American Health Information Management Association and adhere to official coding guidelines.

Comply with HIPAA laws and regulations.

Participate in testing and training as required by the Company.

Qualifications:  

Active nursing license (RN or LPN) and/or certified coder certification through AHIMA or AAPC required

At least one years' experience as a medical coder/abstractor.

Extensive knowledge of ICD-9-CM outpatient diagnosis coding guidelines (with knowledge and demonstrated understanding of CMS HCC Risk Adjustment coding and data validation requirements is preferred);

Ability to code using an ICD-9-CM code book (without using an encoder);

Strong clinical skills related to chronic illness diagnosis, treatment and management;

Reliability and a commitment to meeting tight deadlines (24-hour turnaround time on all assigned charts);

Personal discipline to work remotely without direct supervision;

Exemplary attention to detail and completeness-all medical coders must maintain minimum QA passing requirements based on HCC scoring model(HCCx < or equal to 5 and HCCm < or equal to 5);

Computer proficiency (including MS Windows, MS Office, and the Internet);

Must have high-speed Internet access, a home computer with a current Windows operating system, MS Internet Explorer (version 6.0.2 or better), and Adobe 6.0 or better;

Strong organization skills; interpersonal and customer service skills; written and oral communication skills; and analytical skills;

Knowledge of HIPAA, recognizing a commitment to privacy, security and confidentiality of all medical chart documentation.

1 year of certified coding experience

All your information will be kept confidential according to EEO guidelines.