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

Trinity College

Visiting Assistant Professor in Political Science and Public Policy Job at Trinity College

...Details Position Information Title Visiting Assistant Professor in Political Science and Public Policy Tenure Track or Non Tenure... ...and will include courses in the candidates area of research expertise. We will prioritize candidates with the...

NP Now

Vascular Surgeon Job at NP Now

...Big Texas non-profit Health System seeks a Vascular Surgeon in Longview TX! 1 hour and 45 mins from Dallas Join 800 Physicians! ****@*****.*** -(***) ***-**** Come make a difference within a growing team of providers that focus to enhance the lives they...

Airwallex

Director, Financial Partnerships, Banking Partnerships & New Market Development, Americas Job at Airwallex

.... What youll do The Director of Financial Partnerships, Banking Partnerships & New Market Development will play a critical role... ...management across all banking and fintech relationships in the Americas, including with global partners. Leading a group of geographically...

Interim HealthCare of Redwood City, CA

- Business Development Representative (BDR) - Career Growth Job at Interim HealthCare of Redwood City, CA

Business Development Representative Redwood City and surrounding areasExperience a culture that values and rewards you for the work you do. As a Business Development Representative for Interim HealthCare, youll join a team of professionals that support each other...

QTS Data Centers

Category Sourcing Manager Job at QTS Data Centers

...The Category Sourcing Manager ("CSM") is responsible for developing, executing, and managing corporate sourcing initiatives for a variety of direct and indirect categories, depending on expertise. The CSM will perform complex data analysis to identify new sourcing &...

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

MnZkMU1meXlMYThteWdYRHYwTTliZkt0V3c9PQ==