Job Summary: The Senior Coder is responsible for documentation and coding review of medical records where services are rendered at various partnered medical practices. Will work with assigned provider offices to ensure accurate reporting of diagnoses and service codes to support optimal performance in risk adjustment and quality measurement. The scope of work will include pre, post and wraparound visit input. The Field Coder will be required to work occasionally onsite at the provider office and may require travel to out of state for in person provider education and training. The Senior Coder will be required to maintain consistent and reliable methods of communication to accommodate the hours and demands of providers’ schedules.

Qualifications & Requirements:

• University/college degree, or equivalent medical records, claims or billing experience
• 3+ years in CMS coding and documentation guidelines as well as HCC risk adjustment coding practices
• CRC Required.
• Additional Coding certification preferred (CCS, CPC, or RHIT) Must be credentialed through AAPC or AHIMA.
• 2+ years in Risk Adjustment Coding
• Experience working in a variety of EMRs and the ability to navigate and pick up EMR applications agree
• Strong understanding and knowledge of CMS Coding and Documentation Guidelines agree
• Demonstrated competency in HCC coding practices. agree
• Proficient with MS Office Suite (Word, Excel, Outlook), Internet and databases agree
• Knowledge of age-specific needs and elements of disease processes and related procedures required.
• Strong broad-based clinical knowledge and understanding of pathology/physiology of disease processes.
• Working knowledge of inpatient admission criteria, Medicare reimbursement system and coding systems preferred, but not required.
• Previous medical office experience preferred.
• Ability to read and write effectively in English; bi-lingual Spanish preferred
• Highly organized, proficient critical-thinking and analytical problem-solving skills
• May be required to be available beyond normal 8-5 working hours, including weekends, to accommodate office and provider hours) and to work occasionally onsite at a provider’s office
• Ability to work independently in a time oriented environment is essential.

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