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

VnhLMitwaXJ2T2QxK0FCZS8vVStrb0EwdVE9PQ==
  • 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

Remote work,

Similar Jobs

AAJA25

Executive Editor: Shape the Magazines Vision & Strategy (New York) Job at AAJA25

 ...editors and writers, and overseeing editorial quality across various formats. Candidates should have over 5 years of experience in journalism, exceptional communication skills, and an ability to manage a dynamic team. A competitive salary of $120,000 and comprehensive... 

PBF Energy

Crane Operator/Rigger Mechanic Job at PBF Energy

 ...PBF Energy Inc. (NYSE:PBF) is one of the largest independent refiners in North America, operating, through its subsidiaries, oil refineries and related facilities. We have an opportunity at our Martinez Refinery in California and are seeking a talented Crane Operator... 

J&S Business Solutions

Remote Travel Agent Job at J&S Business Solutions

 ...We are a U.S.-based travel agency seeking motivated individuals to work as independent travel agents in a remote, commission-based role. Responsibilities: Plan and book travel arrangements including flights, hotels, cruises, and vacation packages Consult with... 

Safe Space Handymen, LLC

Experienced Handyman needed. Job at Safe Space Handymen, LLC

Job Description Job Description Full-Time Handyman (1099 Contractor) $20$30/hr + Bonuses Location: Austin, TX & surrounding areas Job Type: Full-Time | 1099 Independent Contractor Pay: $20$30/hour (based on experience) + job completion bonuses ...

1 CLARA MAASS DRIVE

Registered Nurse (RN) Emergency Screening/Behavioral Health Per Diem Nights Job at 1 CLARA MAASS DRIVE

 ...Job Title: RN Per Diem Location: Clara Maass Medical Center Department Name: Emergency Screening Req #: 0000231926 Status: Hourly Shift: Night Pay Range: $46.48 - $62.09 per hour Pay Transparency: The above reflects the anticipated hourly wage range...