Medical Coding Analyst for WellMed

Details: Job SummaryThe Medical Coding Analyst validates progress notes and enters the appropriate ICD-9 coding into the DataRAP® database utilizing the Centers for Medicare and Medicaid Services (CMS) Risk Adjustment Data Validation (RADV) guidelines. This position is also responsible for timely communication of identified quality issues concerning documentation and validation pertaining to the CMS-HCC methodology and ICD-9CM coding guidelines back to the provider.Essential Job FunctionsProcesses attestation sheets and progress notes out of the RightFax work queue according to DataRAP® department guidelines.Analyzes progress notes and documentation sent by providers for validation following CMS guidelines and ICD-9 Coding Manual guidelines and enters final results into appropriate tab of the DataRAP® database.Performs the minimum number of validations consistent with established departmental goals. Provides clear communication, with use of DataRAP® application, through query to PCP on documentation not meeting standard as identified by 'no plan'.Provides clear communication, with use of DataRAP® application, through query to PCP on documentation not meeting standard of basic administrative components to a progress note.Ensures accuracy of entry by comparing to outcome of diagnoses on eAttestation post validation entry.Associates attestation sheets received into the DataRAP® database to provide tracking for all markets.Identifies and reports quality concerns and errors to DataRAP® Clinical Process Quality Analyst for review and education.Responsible for providing coding support to the DataRAP® Clinical Coding Nurses and to the providers participating in the DataRAP® process. Performs all other related duties as assigned.

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