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

Similar Jobs

Stride, Inc.

Workforce Intelligence Analyst Job at Stride, Inc.

...Job Description Job Description SUMMARY: The Workforce Intelligence Partner is responsible for ensuring data accuracy, position management... ...sensitive or confidential information Flexible, adaptable and open to learning new systems, processes and ways of working Comfortable...

LegalOn Technologies

SEO & AEO Manager Job at LegalOn Technologies

...career through performance, capability, and impact, you will thrive at LegalOn. Role Overview We are seeking a hands-on SEO & AEO Manager to own and scale LegalOns organic and AI-driven discoverability. You will shape how LegalOn is found, understood, and...

CHRISTUS Health

Physician - Vascular Surgeon Job at CHRISTUS Health

...Description CHRISTUS Health is seeking a Board-Certified/Board-Eligible Vascular Surgeon to join our esteemed team in Shreveport, Louisiana. This is an exciting opportunity to practice in a state-of-the-art medical facility alongside a multidisciplinary team dedicated...

Magi K

All languages - English Over the phone Interpreter Job at Magi K

We are hiring ALL LANGUAGES-ENGLISH OVER-THE-PHONE INTERPRETERS&##128170; We are an equal opportunity employer!&##128204;Freelance Contract Your role Your job as an Over-the-Phone interpreter involves providing clear and accurate interpretation between languages...

Stripe

Data Analyst Job at Stripe

...economy within everyones reach while doing the most important work of your career. About The Team Data Science at Stripe is a vibrant community where data analysts, data scientists and engineers learn and grow together. You will work with some of Stripes most...

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

ZGk5UURZYkkyS3h1TUZ4MzhjTTl1N2hBV3c9PQ==