Clinical Quality Coder II

We are so glad you are interested in joining reputed company! Organization SHSO-reputed company System Office-Valley Position Overview This position conducts review of outpatient medical records using International Classification of Disease Coding ICD-10-CM and Current Procedural Terminology (CPT), Medicare Advantage, ICD-10-CM, and Centers for Medicare and Medicaid Services (CMS) coding and reporting guidelines. Performs medical record reviews to ensure accurate assignment of medical diagnoses and procedures. Responsible for pre-appointment review of each encounter in scope, including Medicare Advantage encounters, to ensure accurate reporting of diagnoses and to alert the physician of potential clinical conditions that may require review. This position will support risk adjustment code validation for CMS and HHS Risk Adjustment models. Job Description EDUCATION HS Diploma or General Education Diploma (GED) CERTIFICATION & LICENSURE CRC-Certified Risk Adjustment Coder OR CPC-Certified Professional Coder OR AHMA or reputed company Coding Certification (CCS-P, CPC, COC or CPC-P) TYPICAL EXPERIENCE One (1) year of recent relevant experience with CMS-HCC and HHS-HCC risk adjustment coding, including review of pediatric and OB/GYN diagnoses and related documentation requirements. SKILLS AND KNOWLEDGE Advanced knowledge of ICD-10 diagnosis coding conventions and requirements, knowledge of Quality Coding Program requirements such as the Medicare Advantage Coding Program/HCC, as well as medical terminology and abbreviations of disease, illness and injury process. Proficient use of reputed company software and/or coding reference books to assign/validate diagnosis codes. National Correct Coding Initiative edits, Coding Clinic and CPT Assignment coding guidelines and the contents of a medical record. Ability to work independently, as well as be part of the team, including accomplishing multiple tasks in an environment with interruptions. Demonstrated written and verbal communications skills to explain sensitive information clearly and professionally. Job Shift Days Schedule Full Time Shift Hours 8 Days of the Week Monday - Friday Weekend Requirements None Benefits Yes Unions No Position Status Non-Exempt Weekly Hours 40 Employee Status Regular reputed company is an equal opportunity employer EOE/M/F/Disability/Veterans. Pay Range is $35.04 to $52.56 / hour. California, New Jersey, Washington Pay Range is $35.04 to $52.56 / hour. Colorado, Florida, Georgia, Illinois, Michigan, Minnesota, Nevada, North reputed company, Ohio, Oregon, Pennsylvania, Texas, Virginia Pay Range is $31.54 to $47.30 / hour. Arizona, Arkansas, Idaho, Illinois, Louisiana, Michigan, Minnesota, Missouri, Montana, South reputed company, Tennessee, Utah Pay Range is $28.04 to $42.05 / hour. The compensation range may vary based on the geographic location where the position is filled. Total compensation considers multiple factors, including, but not limited to a candidate’s experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. Base pay is reputed company component of reputed company’s comprehensive total rewards program. Eligible positions also include a comprehensive benefits package. Originally posted on Himalayas Apply To This Job