post: Medical Coder
position: Remote, United States
Job Type: Full-time / Permanent
Shift Times: Applicants must be available to work from 6am to 6pm CST.
Pay Rate: $20/hour with benefits – health, dental, vision, short-term and long-term disability insurance, life insurance, parental leave and more!
Applicants must own a Windows-powered laptop/desktop with video capability and a high-speed Internet connection.
Job Summary: We are seeking a medical coder with extensive experience in Risk Adjustment and Hierarchical Condition Category (HCC) coding. The ideal candidate will hold at least CPC or CCS certification from AHIMA or AAPC, with higher levels of certification highly preferred. As a medical coder specializing in Risk Adjustment/HCC, you will play a key role in ensuring accurate and compliant coding in our healthcare organization.
Primary Responsibilities:
- Review and accurately code medical records and consultations for diagnoses and procedures related to risk adjustment and HCC coding guidelines.
- Ensures coding complies with ICD-10-CM, CMS-HCC, and other relevant coding guidelines.
- Verify and ensure the completeness, accuracy and integrity of coded data.
- Identifies and resolves coding discrepancies or inconsistencies between clinical documentation and diagnostic coding.
- Stay current on the latest coding guidelines, rules, and regulations related to risk adjustment and HCC coding.
- Adhere to all compliance and HIPAA regulations to maintain data security and patient confidentiality.
- Collaborates with providers, physicians and other team members to clarify documentation and resolve coding questions.
- Participate in coding education and training programs to enhance your coding skills and knowledge.
- Prepare and submit reports on coding activity, coding accuracy, and coding-related issues and trends.
- Assist with internal and external coding audits to ensure quality and compliance of coding practices.
- Identify opportunities for process improvement and efficiency in the coding process.
- Provides suggestions to improve coding documentation and accuracy.
Requirements
Eligibility:
- At a minimum, CPC or CCS certification from AHIMA or AAPC is required, with higher level certifications such as Certified Risk Adjustment Coder (CRC) being a major advantage.
- Minimum 2 years of experience in risk adjustment and HCC coding in a clinical setting.
- In-depth knowledge of ICD-10-CM coding guidelines and CMS-HCC risk adjustment methodology.
- Familiarity with Electronic Health Record (EHR) systems and coding software.
- Excellent attention to detail, analytical skills and ability to work independently.
- Excellent communication and interpersonal skills to collaborate with healthcare professionals and team members.
- Understanding of compliance and confidentiality regulations, including HIPAA.
About the Company
Advantmed is a privately held company founded in 2005. Initially focused on record retrieval, we have evolved into an innovative health information management company helping health plans and managed care organizations optimize revenue and improve quality outcomes. Our mission is to improve the health system by ensuring appropriate, quality care and reducing unnecessary costs. We achieve this by offering a cost-effective suite of capabilities tailored to our clients’ unique needs, including NCQA-certified HEDIS® measurement software, risk analysis, medical record retrieval, medical record abstraction, risk adjustment coding, data validation, predictive assessment and provider education.
Our strategy reflects our flexibility and commitment to meet the changing needs of our clients. We work closely with our clients to understand their concerns, requirements, strategic goals and infrastructure and support them accordingly. Our guiding principles are accuracy, efficiency and transparency. Our solutions are designed to be user-friendly and flexible.
We see ourselves as an extension of our clients’ internal teams, working to evolve our solutions to meet their growing business needs. Understanding how our clients use our products and services, especially on the technology side, strengthens our product development roadmap as we continually work to improve our client portal. Additionally, we regularly monitor changes in statutes and regulations from CMS, HHS, NCQA, and others.
Advantmed’s leadership team is comprised of experienced healthcare professionals with extensive expertise in quality and risk adjustment. The leadership team oversees a global staff of over 1,800. Notably, the company is HITRUST certified and all data is stored within the United States.
