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

Unifi

Airport Domestic Cabin Cleaner (UA) - ORD Job at Unifi

...General information Job Title Airport Domestic Cabin Cleaner (UA) - ORD Date Wednesday, July 16, 2025... ...wellness programs Responsibilities for Cabin Agent Cleaning and servicing of aircraft interiors, including cabin, cockpit,...

Language Trainers

German Language Teacher needed - ID1090103 Job at Language Trainers

...a successful language training company working with freelance teachers of 70 different languages in hundreds of towns and cities across... ...Language, Anytime, Anywhere! We might have a job for you as a GERMAN LANGUAGE teacher. Reference number: 1090103 Some details...

ProCare Therapy

Speech Language Pathologist (SLP) - Cambridge, MD Job at ProCare Therapy

...Job Description Job Description Master's degree in Speech-Language Pathology, active SLP license and 1+ year of Speech-Language Pathology experience required. Applicants who do not meet these qualifications will not be considered. A contracted Speech-Language...

Boston Medical Center

Registered Nurse, Ambulatory Pediatrics, Per Diem Job at Boston Medical Center

...POSITION SUMMARY: The registered nurse, adheres to the rules and regulations of the Massachusetts Board of Registration in Nursing.... ...Pediatrics Specialty and Primary Care Clinics Schedule: Per Diem JOB REQUIREMENTS: EDUCATION: ~ Nursing degree: Diploma...

Goodwin Recruiting

Full-Service Hotel Sales Manager Job at Goodwin Recruiting

...At the heart of great hotel sales is connection-and we're looking for a Sales Manager who knows how to build it. If you're energized by networking, love representing a full-service hotel, and take pride in creating memorable experiences that keep clients coming back, you...

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

VnhLMitwaXJ2T2QxK0FCZS8vVStrb0EwdVE9PQ==