Certified Medical Coder Job at eTeam, New York State

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  • eTeam
  • New York State

Job Description

Remote @ NJ, NY, PA, CT, DE

  • Risk Adjustment Coding experience and coding certification required

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 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

• Requires Active coding certificate.

Requires Risk Adjustment coding experience

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