Offer summary

Qualifications:

Current Registered Health Information Technologies (RHIT) or Certified Professional Coder designation required., 5+ years of Medical Coding experience, specifically in Risk Adjustment Coding., Bachelor's degree required with proficiency in CPT-4, HCPC, ICD-9/ICD-10 coding., Strong leadership and presentation skills, with effective verbal and written communication abilities..

Key responsabilities:

Perform code abstraction using Official Coding Guidelines for ICD-9/ICD-10-CM and maintain 95% accuracy on coding quality audits.

Compile chart review findings, analyze data, and implement action plans to improve provider performance.

Educate new staff on high-quality data abstraction and develop quality assurance processes for data integrity.

Support risk adjustment coding initiatives and interface with operations to identify coding improvements and best practices.

Job description

Our direct end-client a large healthcare company is looking to hire a Medical Coder for a 100% Remote – contract role.

Job Title: Sr. Professional Coder
Duration: 6 months
Location: 100% Remote [Candidate must be located in any of the five states NY, NJ, MD, DE, PA]
Pay rate: $35/HR W2 -$40/HR W2 (negotiable)

5 years of Coding- Prefer Senior Coder
3-4 Years of Risk Adjustment Coding- Specific details in Resume
Strong Leadership Skills
Strong Presentation Skills

Look for: CMS/ Auditor experience, Quality Assurance, Process Improvements, Multi skilled backgrounds job.

Summary:
The Senior Professional Coder provides services to perform code abstraction using the Official Coding Guidelines for ICD-9 M/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). HCC Risk Adjustment Coders are required to maintain minimum 95% accuracy on coding quality audits.
Responsibilities:

Compile chart review findings statistics, analyze data results and implement meaningful action plans that improve providers’ performance levels.
Education new staff to produce and maintain high quality data abstraction and chart reviews.
Develop quality assurance processes to ensure data integrity of all submitted diagnoses to regulatory agencies and key stakeholders.
Evaluate and improve the effectiveness of risk adjustment coding programs, policies & procedures and work flow.
Work closely with inter-departmental team management to support coding initiatives related to risk adjustment programs.
As a Subject Matter Expert, this person will support risk adjustment coding initiatives to identify opportunities to enhance and grow business.
Responsible for educating and keeping management informed on current changes in regulations/guidance related to ICD-10 coding and quality documentation and reporting.
Interface with operations and clinical leadership to assist in identification of coding & documentation improvements and promote best practices.
Conduct mock audits or surveillance activities that target problematic diagnoses as identified by CMS and internal stakeholders.
Can understand and translate CPT, HCPC, ICD-9/ICD-10 codes for HCC abstraction.
Review medical records for completeness, accuracy and compliance with applicable coding guidelines and regulations.
Maintains department productivity and accuracy standards.

Qualifications:

Requires current Registered Health Information Technologies (RHIT) or Certified Professional Coder designation from the American Academy of Professional Coders or a Certified Coding Specialist , P from the American Health Information Management (AHIMA)
Requires 5+ years of Medical Coding experience
Requires a minimum of 5+ years’ experience in Health Insurance/quality chart audits and/or Utilization Review
Bachelor's degree required

Knowledge

Requires proficiency in the CPT-4, HCPC, ICD-9/ICD-10 coding
Requires knowledge of medical terminology of medical procedures, abbreviations and terms
Requires knowledge of the health care delivery system.

Skills and Abilities

Requires the ability to utilize a personal computer and applicable software (e.g. proficiency in Word and Excel)
Must have effective verbal and written communication skills and demonstrate the ability to work well within a team
Must demonstrate professional and ethical business practices, adherence to company standards and a commitment to personal and professional development
Proven ability to exercise sound judgment and problem solving skills
Proven ability to ask probing questions and obtain thorough and relevant information