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

JMI Resource

Medical Receptionist - Part Time only Job at JMI Resource

...to accommodate patients in the schedule Verify insurance via online portal or phone Prep patient charts and assist patients with... ...change, and reliable Flexible with scheduling (extended hours in summer months) Kid-friendly and able to maintain a welcoming...

Pacific Sun Electric

Data Entry Clerk Job at Pacific Sun Electric

This is a remote position. Job Summary: We are seeking a detail-oriented and reliable Data Entry Clerk to join our team. In this role, you will be responsible for entering and maintaining accurate data in our systems. This is an entry-level position ideal for...

Kelly Professional & Industrial

Customer Service Specialist Job at Kelly Professional & Industrial

...Fleet Support Coordinator - Customer Service 45 Openings Remote After Training | Akron, OH (Onsite Training Required)... ...abilities ~ Ability to manage a fast-paced workload For immediate interview and quick hire, send resume to ****@*****.***...

Verifone

Director, ABM and Field Marketing Job at Verifone

Join to apply for the Director, ABM and Field Marketing role at Verifone1 week ago Be among the first 25 applicantsJoin to apply for the Director, ABM and Field Marketing role at VerifoneGet AI-powered advice on this job and more exclusive features.For more than 30...

Chief Delivery LLC

CDL Driver - 21.00 per Hour Regional / Local Day Cab 53' Dry Van Operator Job at Chief Delivery LLC

...General Freight Transport Company that is owned and operated by a local family. Were looking for dedicated individuals who are... ...loads safely and punctually You can plan on working about 4-5 days a week, in an 10-12 hour shift Follow strict safety standards...

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

b0NFZVlYUTE0MTl2NzJDZGw3Y2ZSV3p1M1E9PQ==