Coder Job Description:
Remote Certified Coders review medical records and apply appropriate ICD–10-CM diagnostic codes and Change Healthcare Flagged Event. Codes must meet Change Healthcare QA standards (following both Official Coding Guidelines and Risk Adjustment Guidelines).
• Assign appropriate ICD–10-CM codes, mapping to risk adjustment models as applicable.
• Assign Change Healthcare Flagged Event codes when documentation in the record is inadequate, ambiguous, or otherwise unclear for medical coding purposes.
• Remain current on diagnosis coding guidelines and risk adjustment reimbursement reporting requirements.
• Check chart assignments every day and accurately report all hours worked on a weekly basis.
• Maintain quality and production standards required by company.
• Report work-related concerns to assigned Coder Advocate and, if not adequately addressed, to Sr.
Manager of Clinical Operations.
• Comply with the Standards of Ethical Coding as set forth by the American Health Information Management Association and adhere to official coding guidelines.
• Comply with HIPAA laws and regulations.
• Participate in testing and training as required by the Company.
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Active certified coder certification through AHIMA or AAPC required (CRC, CPC, CCS - P). CCA, CPC-A are not accepted.
• At least two years of experience as a certified coder is required.
• Extensive knowledge of ICD-10-CM outpatient diagnosis coding guidelines (knowledge and demonstrated understanding of Risk Adjustment coding and data validation requirements is highly preferred);
• Ability to code using an ICD-10-CM code book (without using an encoder);
• Strong clinical knowledge related to chronic illness diagnosis, treatment and management;
• Reliability and a commitment to meeting tight deadlines (24-hour turnaround time on all assigned charts);
• Personal discipline to work remotely without direct supervision;
• Exemplary attention to detail and completeness-all medical coders must maintain minimum QA passing requirements based on HCC scoring model (HCCx < or equal to 5 and HCCm < or equal to 5);
• Computer proficiency (including MS Windows, MS Office, and the Internet);
• Must have high-speed Internet access, a home computer with a current Windows operating system, MS Internet Explorer (version 6.0.2 or better), and Adobe 6.0 or better;
• Strong organization skills; interpersonal and customer service skills; written and oral communication skills; and analytical skills;
• Knowledge of HIPAA, recognizing a commitment to privacy, security and confidentiality of all medical chart documentation.
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