Job Description

We're Hiring: Sr. Medical Coder!
We are seeking an experienced and detail-oriented Sr. Medical Coder to join our healthcare team. The ideal candidate will have extensive knowledge of medical coding systems, healthcare regulations, and quality assurance processes to ensure accurate coding and compliance with industry standards.
Location: Rochester, NY
Role: Sr. Medical Coder
Responsible for reviewing medical records to abstract ICD10 codes that map to HCCs from a variety of different CMS Hierarchy models including Medicare Advantage, PACE, Commercial, and Medicaid CDPS model. In addition to abstracting diagnosis codes, the Clinical Review Specialist also audits medical records and validates entries that have been submitted to CMS.
Responsibilities
Conducts audits of medical records (paper, EMR, hybrid)
Adheres to compliance of Medicare, Medicaid, and Commercial risk adjustment guidelines with precision.
Understands, respects, and applies client specific guideline
Adheres to audit and medical record review schedules to meet client expectations and government-regulated deadlines
Regularly participates in peer review; provide and receive feedback
Ensures accurate documentation to support all audits
Assures adherence to and currency with internal and external regulatory guidelines:
CMS/HHS
DOH
HIPAA, HITECH, and Fraud Waste & Abuse
Medical coding protocols
Maintain coding credentials as required by credentialing agency
REQUIREMENTS:
Coding Certification: CPC, CCS, RHIT, or RHIA
Possess at least 5 years of experience of with ICD-9, ICD-10, CPT and HCPC coding systems
Proficiency in MS Office tools such as Word, PPT, Excel and be comfortable learning and becoming an expert on new and proprietary software
PREFERRED QUALIFICATIONS:
Have strong written and verbal communication skills, including propensity to establish and build strong relationships.
Take initiative to establish priorities, coordinate work activities and perform multiple and complex tasks while working independently and with minimal supervision in a remote setting.
Ability to consistently meet established minimum quality standards in a heavy production environment
Must be able to meet organization production and accuracy goals
CRC Certification
Documentation Improvement experience, experience in Hierarchical Condition Categories (HCC), knowledge of or experience in Medicare Advantage plans and knowledge of or experience in managed health care systems, PACE or Medicare are plusses
Ready to make an impact? Apply now and let's grow together!

Job Tags

Remote work,

Similar Jobs

CTC Global Corporation

NetSuite Analyst Job at CTC Global Corporation

...000 Shift: Day, Monday to Friday, 8 AM to 5 PM SUMMARY The ERP Analyst will support currently being implemented NetSuite ERP system. Analyze business requirements and implement changes when and where necessary. The Analyst must follow best practices and...

Lions Den Coffee Shop - Plantsville

Baker At Lions Den Coffee Shop Plantsville Job at Lions Den Coffee Shop - Plantsville

...Job Description Job Description Lions Den Coffee Shop in Plantsville, CT is looking for one baker to join our 26 person strong team. We are located on 57 West Main Street. Our ideal candidate is self-driven, ambitious, and engaged. Benefits ~ We offer many great...

SynergisticIT

Entry Level Java Developer (Chicago) Job at SynergisticIT

Job Title SynergisticIT understands the complex nature of the job market and how difficult it can be to secure a position, especially for fresh graduates. Therefore, we assist and help tech-savvies to convert their passions into professions. We go above and beyond to...

Tastewise

Product Marketing Manager Job at Tastewise

...from billions of data points, we empower our clients to create, market, and sell their products faster and more successfully.... ...outside this range, we encourage you to apply still . ~ Visa sponsorship for this role is currently not available. Equal Opportunity...

Allied Universal®

Security Shift Supervisor Job at Allied Universal®

...Job Description Allied Universal, North Americas leading security and facility services company, offers rewarding careers that provide you a sense of purpose. While working in a dynamic, welcoming, and collaborative workplace, you will be part of a team that contributes...

Sr. Medical Coder Job at Tap Growth ai, Rochester, NY

TW5yTTNBejhxT0dsRHhGaTZxdVBRV0VaM0E9PQ==