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

SHkySXhaWmN6Rmw4cU44SDNnRjRpeWx5cmc9PQ==
  • 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

Similar Jobs

Somewhere

Virtual Assistant - 42851553628 Job at Somewhere

Seeking LATAM-based candidates who are LATAM citizens. Only English CVs will be accepted. Position : Executive Assistant Working Schedule : 9a-5p EST (Can vary based on the CEO location) Salary Range :$1400-$1700 USD Monthly (the final salary will be determined... 

Yexgo

Typist - Data Entry Specialist (Work From Home) Job at Yexgo

 ...degree a plus) Basic computer and communication skills Strong organizational and time management abilities Ability to work independently or as part of a team Adaptable and willing to learn new tools or systems Reliable and responsible work ethic... 

Nachhilfeunterricht

Remote Private English tutor Job at Nachhilfeunterricht

 ...: Pay between 15 and 35 per hour (without commission!) Flexible working hours and location: work when and where you want (online or on-site) To become part of our tutoring team, it is not necessary to submit your resume. We are looking forward to meeting you... 

Canacre

Environmental Monitor - CPESC Job at Canacre

 ...Our vision is to foster an environment that promotes inspired and empowered team members who make an impact. The Environmental Monitor - Certified Professional in Erosion Sediment Control (CPESC) will monitor and report on construction-related activities with respect... 

Spotter

Quality Assurance Engineer -- Junior Product Manager | AI... Job at Spotter

 ...candidate will have a deep understanding of trucking operations and a passion for ensuring the highest quality of our software products. While extensive tech experience is not required, a willingness to learn and adapt to new tools and technologies is essential....