Falconet Precise Coding Solutions is seeking a dedicated and detail-oriented ADR Specialist to join our ​dynamic team. As an ADR Specialist, you will play a vital role in ensuring accurate and compliant ​medical coding for home health services. This position offers a unique opportunity to work remotely ​while contributing to the success of our growing company.

Responsibilities:

• Review and analyze documentation to identify discrepancies or inconsistencies in medical records ​related to home health services.
  
• Ensure that all coding and documentation comply with regulatory requirements, including Medicare ​guidelines, local coverage determinations (LCDs), and national coverage determinations (NCDs).
  
• Manage the process of responding to Additional Documentation Requests (ADRs) from Medicare ​Administrative Contractors (MACs) and other payers.
• Collaborate with clinicians, coders, and other healthcare professionals to obtain additional ​documentation or clarification as needed.
• Maintain accurate records of ADRs, including tracking timelines and outcomes of responses.
• Provide education and training to coding and clinical staff on ADR documentation requirements and ​best practices.
• Stay informed about changes in coding guidelines, regulations, and reimbursement policies relevant ​to home health services.
• Participate in audits and quality assurance activities to ensure coding accuracy and compliance.
• Contribute to the development and implementation of process improvements to enhance efficiency ​and productivity within the coding department.
• Adhere to strict confidentiality and security standards when handling sensitive patient information.

Requirements:

• Certified Professional Coder (CPC) credential or equivalent coding certification required.
• HIPAA Certificate is a must.
• Minimum of 2 years of experience in medical coding, with specific experience in home health coding ​preferred.
• Thorough understanding of ICD-10-CM, CPT, and HCPCS coding systems, as well as coding ​guidelines and regulations.
• Familiarity with Medicare regulations and documentation requirements for home health services, ​including face-to-face encounter documentation and OASIS assessments.
• Excellent analytical and critical thinking skills, with the ability to interpret complex medical ​documentation.
• Strong communication and interpersonal skills, with the ability to effectively collaborate with ​multidisciplinary teams.
• Detail-oriented approach with a commitment to accuracy and quality.
• Proficiency in using coding software and electronic health record (EHR) systems.
• Ability to work independently and manage multiple tasks efficiently in a remote work environment.
• Commitment to ongoing professional development and staying abreast of changes in the coding ​field.