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Job Title: Clinical Data Abstraction Specialist Supervisor: Director, VBC Operations Required License(s)/ Certification(s): Certified Risk Adjustment Coder (CRC), Certified Professional Coder (CPC), or Certified Coding Specialist (CCS) FLSA Status: Nonexempt Summary: Clinical Data Abstraction Specialist is responsible for reviewing, abstracting, and coding inpatient and/or outpatient medical records to ensure proper ICD-10 coding and compliance with risk adjustment requirements. Essential Duties and Responsibilities include the following. Other duties may be assigned. Candidate Qualifications Follows CMS Risk Adjustment guidelines and has a complete understanding of these guidelines. Reviews submitted medical records to identify ICD-10-CM diagnoses, ensuring the documentation meets all CMS standard requirements for valid submission. Codes all diagnoses and services accurately and completely, from the medical record in accordance with the ICD10-CM coding classification systems. Selects and accurately records all appropriate records and data on assigned chart abstraction projects. Ability to meet productivity and accuracy standards. Tracking and monitoring of medical records requests for all risk adjustment projects. Performs telephonic outreach to provider practices and/or facilities to request medical records electronically or on-site. Performs other duties as assigned. LICENSES/CERTIFICATIONS: A certification in one of the following is required: Certified Risk Adjustment Coder (CRC) Certified Professional Coder (CPC) Certified Coding Specialist (CCS) Education High School Diploma or GED Required Skills Knowledge of healthcare delivery systems. Strong oral and written communication skills. Ability to work in a fast-paced environment with changing priorities. Ability to work with others in a mixed matrix environment. Demonstrated written communication skills. Demonstrated time management and priority-setting skills. Demonstrated problem-solving and analytical skills. Demonstrated organizational skills. - Demonstrated ability with an electronic health record and practice applications and websites. - Maintain up-to-date knowledge of clinical documentation standards and best practices. TECHNICAL SKILLS: Working knowledge of Microsoft Office Working knowledge of Electronic Health Records (EHR) Experience Minimum of three (3) years HCC experience performing retrospective risk adjustment chart review required. Minimum of three (3) years of experience in a hospital, a physician setting or a Managed Care Organization as a medical coder. Minimum of five (5) years ICD-10 CM coding experience required. Current AAPC or AHIMA credential required. Managed Care Experience preferred. Knowledge of Medicare Risk Adjustment required. About Apex Health Solutions Apex Health Solutions powers payers and providers choosing to engage in value-based risk contracting. Apex s unique solutions create alignment between payers and providers, generating unparalleled value. Combined with Apex s experienced and successful industry leadership, our focal point remains on improvement in patient quality, satisfaction and overall cost of care.