Coder - Full Time - Temporary Position

Description

Job summary

The role of the Certified Medical Coder is to review and perform code abstraction using the Official Coding Guidelines for ICD-9-CM/ICD-10-CM, AHA Coding Clinic Guidance, and in accordance with all state regulations, federal regulations, internal policies, and internal procedures. HCC Risk Adjustment Coders will be involved with activities of code abstraction for the following programs; including but not limited to, Commercial Risk Adjustment, Medicare Advantage Risk Adjustment, Commercial IVA (Initial Validation Audit), and Medicare RADV (Risk Adjustment Data Validation).

Position Essential Functions:

• Responsible for maintaining current knowledge of coding guidelines and relevant federal regulations using current ICD-10-CM materials, HCC risk models, and other pertinent materials.
• Maintain adequate knowledge of coding, compliance and reimbursement procedures related top Medicare Risk Adjustment.
• Must demonstrate knowledge of coding multiple areas of service and/or specialties or extensive experience in a specific specialty deemed a critical business need by PopHealthCare Coding Leadership.
• Meeting and/or exceeding designated productivity set by PopHealthCare Coding Leadership and coding accuracy rate of 95% Accuracy and 95% Completeness.
• Verify and ensure the accuracy, completeness, specificity and appropriateness of diagnosis codes based on services rendered. Accesses several systems via the computer to research the medical record when needed to complete the coding in a timely manner.
• Meet minimum productivity requirements as outlined by the project
• Ensures adherence to PopHealthCare and Departmental Policies and Procedures.
• Practice and adhere to the PHC chart Crew Mission Statement
• Assist coding leadership by making recommendations for process improvements to further enhance coding quality goals and outcomes
• Must be able to continuously work committed schedule in a remote (and secure) setting while maintain availability to attend any/all mandatory department meetings.
• Responding timely to email and/or telephonic communications 11.2015
• Implementation/Execution: Able to organize and manage multiple priorities and/or projects by using appropriate methodologies, tools and applications.
• Demonstrates flexibility and willingness to embrace change
• Maintains strictest confidentiality.
• Enhances professional growth and development through in-service meetings, educational programs, conferences, etc.
• Handle other related duties as required or assigned
• Ensure safety and confidentiality of data and systems by adhering to the organizations information security policies
• Read, understand and agree to security policies and complete all annual security and compliance training

Qualifications

Position Requirements:

•     Must be in good standing with either AAPC and/or AHIMA and hold an active CPC,  CRC,CPC-P, CCS, CCS-P or PCS with high degree of competence in this area plus
• 2 yrs. prior work experience in the healthcare field specifically related to coding is preferred.
•     Prior medical chart auditing/quality experience preferred.
•     Advanced knowledge of medical terminology, abbreviations, anatomy and physiology, major disease processes, and pharmacology.
•     Understanding the ICD-10 coding and HCC (hierarchical condition category) coding.
•     ICD-10 Proficiency is required.
•     CPT coding experience is a plus
•     National RAD-V/ HEDIS abstraction experience is a plus.
•     Clinical Care experience is a plus.
•     Managed Care methodology experience a plus.
•     Experience in review/audit of medical records coding and development of process improvement plans required.
•     Access to / maintenance of reliable internet service with enough internet speed.  Sufficient ranging from 3 MBPS and higher.