<p>Under minimal supervision, ensures accurate & appropriate documentation through chart audits as well as provider education and monitoring. Provides documentation coaching and feedback to HCC coding auditors and Prospect Medical network of providers based off encounter audit findings. Monitors and tracks success of training and clinician feedback through encounter audits which ensure documentation meets requirements for diagnosis assignment, based on official ICD guidelines.</p> <p>Abstract pertinent information from assigned medical records using ICD-9-CM, ICD-10-CM, CPT and/or HCPCS codes.</p> <p>Provide detailed comments/feedback on physician performance based on encounter audits.</p> <p>Document detailed chart audit findings including all documentation errors; medical record errors; diagnosis errors as well as missed HCC opportunities.</p> <p>Identify documentation training and HCC coding review training opportunities.</p> <p>Encounter audits will be the primary monitoring tool used to identify operational and regulatory issues related to coding, documentation, and compliance requirements and to ensure complete and accurate data capture in compliance with Federal and State requirements.</p> <p>Monitor corrective actions for audit review findings.</p> <p>Serves as a local resource in meeting internal and external regulatory requirements (e.g., Centers for Medicare & Medicaid Service (CMS), National Committee for Quality Assurance (NCQA)).</p> <p>Actively participate with local CMS (Center for Medicare/Medical Services) team to ensure local objectives are met and regional CMS compliance activities are supported.</p> <p>Works with medical center leadership to provide confidential audits and feedback on an "as needed" basis.</p> <p>Assist in the identification of operational processes that hinder encounter data capture.</p> <p>Prepare and/or perform auditing analysis and/or special projects as assigned.</p> <p>Provide feedback on noncompliance issues detected through auditing.</p> <p>Provide audit support to the HCC Risk Adjustment program specifically the yearly Wellness Visit Program.</p> <p>Submit bi-weekly and monthly audit finding reports.</p> <p>Minimum Education:?A High School Diploma or Equivalent; BS/BA preferred.</p> <p>Minimum Experience:?Five or more (5+) years experience in healthcare setting related to HCC Risk Adjustment and/or chart auditing.</p> <p>Req. Certification/Licensure:?Must possess and maintain an AAPC or AHIMA certification - CCS, CCS-P, CPC, CPC-H, CPC-P, RHIT, RHIA.</p>