Summit Medical Group is seeking a Pre-Visit Planning Coder to support risk adjustment, HCC coding, and quality measure documentation review for its onsite team in the Knoxville, TN area.
The role focuses on reviewing medical records, progress notes, diagnosis documentation, and supporting data sources to ensure accurate and complete ICD-10-CM and CPT coding. The coder will help identify gaps in documentation, assist providers in updating active problem lists, support HEDIS and CMS Stars quality efforts, and communicate coding-related findings to providers and internal teams.
This position also participates in educational efforts, quality improvement activities, and risk adjustment projects to improve coding accuracy, documentation integrity, and regulatory compliance.
Qualifications
- Associate degree required; bachelor's degree preferred
- Coursework in ICD-9-CM, ICD-10-CM, CPT coding, anatomy and physiology, and medical terminology
- Current credential required: RHIA, RHIT, CCS, CCS-P, CPC, CPC-H, and/or CRC
- If not CRC certified, certification must be obtained within the first year of employment
- AHIMA/AAPC certification must be maintained through continuing education
- Proficient computer skills
- Ability to interpret, analyze, and abstract data/documentation
- Strong problem-solving skills
- Self-motivated with independent thinking, time management, and organizational skills
Preferred Experience
- 2–5 years of coding experience with ICD-10 and CPT code conventions
- Risk adjustment and HCC coding experience
- Experience with CMS Medicare Advantage Risk Adjustment Data Validation (RADV)
- Prior medical chart auditing and quality reporting experience
- Managed care experience
- Knowledge of health plan risk adjustment processes and CMS RAF assignment and acceptance
- Clinical experience is beneficial
Location
Tennessee, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
1 month ago