Job Description

• Abstracts, sequences and assigns diagnosis and procedures codes according to CMS HCC and all CPT and ICD 9 & 10 guidelines

• Effectively uses computer assisted coding tools to review and interpret medical records and applies in-depth knowledge of coding principles to validate missing, incomplete or incorrect CPT and diagnosis codes

• Demonstrates advanced knowledge of medical terminology, anatomy and physiology

• Follows up on all outstanding and incomplete provider billing summaries to ensure proper coding

• Manages individual and team quality of work toward meeting or exceeding SLA targets

• Manages individual and team productivity toward meeting or exceeding SLA targets


• Bachelor’s degree holder • Must have 10 years’ experience in coding or relevant experience within a Health Plan • Must have at least 2 years of Medicare Advantage & Affordable Care Act HCC / risk adjustment coding experience • Required Licensure and Certification: CPC (Certified Professional Coder through American Academy of Professional Coders) or CCS-P (Certified Coding Specialist Physician based through American Health Information Management Association) • Must have extensive knowledge of ICD-10-CM outpatient diagnosis coding guidelines • Strong understanding of the HCC concepts and impact on Population Health Risk Adjustment reimbursement initiatives • 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) • Knowledge of HIPAA recognizing a commitment to privacy, security and confidentiality of all medical charts. • Ability to code using an ICD-9-CM and/or ICD-10-CM code book (without using an encoder) • EMR/EHR experience

All employment decisions shall be made without regard to age, race, creed, color, religion, sex, national origin, ancestry, disability status, veteran status, sexual orientation, gender identity or expression, genetic information, marital status, citizenship status or any other basis as protected by federal, state, or local law.

Job candidates will not be obligated to disclose sealed or expunged records of conviction or arrest as part of the hiring process.

Accenture is committed to providing veteran employment opportunities to our service men and women.

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