Certified Medical Coder I (REMOTE)

<strong>Working at Advantasure is more than a job &mdash; you&rsquo;re part of a team that is becoming the country&rsquo;s leading healthcare solutions provider.<br /></strong><br /><strong>A career at Advantasure means you&rsquo;ll be part of one of the most dynamic, diversified and innovative healthcare companies in the nation. You&rsquo;ll be helping our clients make their members healthier &mdash; and our communities a better place to call home.</strong>

United States, USA


<p class="p1"><strong>At Advantasure, we partner with healthcare clients to simplify their operations and accelerate their business success. Powered by our broad expertise and a comprehensive suite of product and service solutions, we help health plans effectively navigate the complexity of healthcare.</strong></p> https://advantasure.com/

keywords: job description,records,compliance,education,experience,knowledge,skills


Competitive Compensation and Benefits Package

Overview: <br /><br />Certified MRA Coder I, will perform Retrospective Review to assist healthcare providers in identifying and resolving issues related to incomplete or missing clinical documentation. Increase accuracy, completeness, and compliance with clinical condition documentation to enable providers to deliver quality of care.<br /><br /> <p><strong>WORKING CONDITIONS:</strong></p> <p>Work is performed remotely.</p> <p>&nbsp;</p>
Responsibilities: <br /> <ul> <li>Ensures compliance with all applicable Federal, laws, and regulations related to coding and documentation guidelines for Commercial and Medicare Risk Adjustment Payment System.&nbsp;</li> <li>Performs remote medical record review to capture all relevant diagnosis codes included in the CMS and HHS Hierarchical Condition Categories (HCC) conditions for Commercial and Medicare Risk Adjustment Payment system.&nbsp;</li> <li>Focus on retrospective coding to close HCC gaps and add HCC codes not reported.</li> <li>Ensure diagnosis codes are supported by the documentation and ensure adherence with ICD-10CM Guidelines for Coding and Reporting.</li> </ul>
Requirements: <br /><br /> <p><strong>EDUCATION:</strong></p> <ul> <li>High School degree or equivalent required.&nbsp;</li> <li>Bachelor&rsquo;s degree in a related field preferred.&nbsp;</li> <li>Successful completion of a coding license or certificates; CPC, COC, CRC, CCS, CCS-P.&nbsp;</li> <li>Continuous learning, as defined by the Company&rsquo;s learning philosophy, is required.&nbsp;</li> <li>Certification or progress toward certification is highly preferred and encouraged.</li> </ul> <p>&nbsp;</p> <p><strong>EXPERIENCE:</strong></p> <ul> <li>One (1) year HCC coding experience.&nbsp;</li> <li>Experience and understanding of CMS HCC Risk Adjustment coding and data validation requirements.&nbsp;&nbsp;</li> <li>Successful completion of a coding certificate program.</li> <li>CPC, COC, CRC from AAPC or CCS-P, CCS, from AHIMA.&nbsp;</li> <li>Initial demonstration and maintenance of continuing education/membership are required.</li> </ul> <p>&nbsp;</p> <p><strong>SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:&nbsp;</strong></p> <ul> <li>Excellent organization and problem-solving skills.</li> <li>Strong oral and written communication skills.</li> <li>Advanced understanding of medical terminology, pharmacology, body systems/anatomy, physiology, and concepts of disease processes.</li> <li>Extensive knowledge of and ICD-10CM coding guidelines and AHA Coding Clinic.</li> <li>Advanced technical skills for use of MS Office (Excel, Word, Outlook, and PowerPoint) as demonstrated through successful completion of a skills test.&nbsp;</li> <li>Demonstrated ability to utilize a variety of electronic medical records systems.&nbsp;</li> <li>Ability to manage a significant workload, and to work efficiently under pressure, while meeting established deadlines with minimal supervision.</li> <li>Demonstrated ability to communicate clearly and effectively with a wide variety of individuals at all levels of the organization.</li> <li>Strong time management skills.</li> <li>Must possess a high degree of accuracy, efficiency, and dependability.</li> <li>Excellent written and oral communication for representation of clear and concise results.&nbsp;</li> </ul>