MRA Coder – Volusia County

Job Description

Position Summary

The Medicare Risk Adjustment (MRA) Coder ensures all significant chronic conditions found in the patient’s chart affecting the risk score are identified to allow the Clinical Provider to determine which conditions are current so they can be addressed during the patient visit. This role is also responsible for   proper identification of respective ICD-10 codes to ensure the accuracy of billing for addressed diagnoses. In addition, the MRA Coder provides educational support regarding complete documentation.

Essential Duties and Responsibilities

The essential functions include, but are not limited to the following:

• Review complete chart including progress notes, consultations, and hospital discharge reports and flag definitive risk-adjustment diagnoses.
• Document found diagnoses with respective codes and location of definitive diagnosis.
• Maintain binders for pre and post-visit chart review including reviewing patient records before scheduled visits and updating the patient’s MRA card as needed
• Review post-visit progress notes, ensuring supporting documentation and ICD-10 codes are accurate
• Ensure all significant chronic conditions are identified and documented in patient’s chart to ensure that the Clinical Provider can discuss conditions during patient visits
• Meet with affiliate staff to address observed trends, provide education, and provide a list of encounters to rebill that do not appear on Prostar.
• Work on other MRA projects as assigned.
• Perform other duties as assigned.

Minimum Qualifications (Knowledge, Skills, and Abilities)

• High School graduate or equivalent required.
• CPC or CPC-A required. VP may consider non-certified coder if schooling has been completed and studying for AAPC exam. Non-certified hire must continue to sit for exam until certification is achieved.
• 1-year medical office experience required.
• Ability to stay current on Medicare Risk Adjustment education and CMS updates.
• Ability to utilize CMS spreadsheets with risk adjusted diagnosis data and ICD-10 book for proper identification of risk adjusted diagnosis and codes
• Medicare Risk Adjustment experience preferred.
• Microsoft Office experience preferred.
• Must possess excellent communication skills including telephone skills.
• Ability to stay focused and give great attention to detail.

Physical Demands and Work Environment

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the functions.

While performing the duties of this position, the employee is regularly required to talk or hear. The employee frequently is required to use hands or fingers, handle or feel objects, tools, or controls. The employee is occasionally required to stand; walk; sit; and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this position include close vision, distance vision, and the ability to adjust focus. The noise level in the work environment is usually low to moderate.

Note

This job description in no way states or implies that these are the only duties to be performed by the employee(s) incumbent in this position. Employees will be required to follow any other job-related instructions and to perform any other job-related duties requested by any person authorized to give instructions or assignments. All duties and responsibilities are essential functions and requirements and are subject to possible modification to reasonably accommodate individuals with disabilities. To perform this job successfully, the incumbents will possess the skills, aptitudes, and abilities to perform each duty proficiently. Some requirements may exclude individuals who pose a direct threat or significant risk to the health or safety of themselves or others. The requirements listed in this document are the minimum levels of knowledge, skills, or abilities. This document does not create an employment contract, implied or otherwise, other than an “at will” relationship.

The company is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.