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

cCtFNHlNR25TWHFocXRMeExuY2QrRzhyZWc9PQ==
  • Tap Growth ai
  • Rochester, NY

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

SEIU Healthcare 1199NW

Union Organizer Job at SEIU Healthcare 1199NW

 ...SEIU Healthcare 1199NW Union Organizer For Washington state NEW Positions with a Progressive Union! SEIU Healthcare 1199NW, a progressive healthcare union is part of the fastest growing union in the country. We are a union of 37,000 healthcare workers... 

JM Family Enterprises

Auto Transportation Supervisor Job at JM Family Enterprises

Auto Transportation Supervisor Location Jacksonville, FL : Position Summary: The Director of Global Logistics is a key leader in the Logistics and Fulfillment organization. In this role, you will create a vision for global logistics, build a strategy and ensure the talent... 

University of Rhode Island

Assistant Teaching Professor of Health and Physical Education Job at University of Rhode Island

 ...Assistant Teaching Professor of Health and Physical Education Job Description Summary...  ...curriculum and instruction, and evidence-based educational leadership and policy practices...  ...range of school settings. Experience in online teaching and learning. ________________... 

Jacobs

Chemical Process Engineer Job at Jacobs

 ...optimism and focus. We don't settle until we give our best and know that we're making a difference. We're looking for a Chemical Process Engineer who is excited about working on projects that enable the heart of our clients' business . This is a hybrid position in... 

Virginia Mason Franciscan Health

Patient Experience Program Manager Job at Virginia Mason Franciscan Health

 ...professional expertise and guidance to site-based management, medical providers and staff in support...  ...of a strong and sustainable culture of patient-centered care that helps to deliver on...  ...advantage. Inasmuch as patient experience is a mission-critical key to the future...