Job Description

SUMMARY The Medical Coder II position performs coding services for the organization to ensure proper reimbursement and compliance with correct coding guidelines. This individual requires skills in sequencing diagnosis/procedure codes to optimize reimbursement. ESSENTIAL DUTIES AND RESPONSIBILITIES Evaluate medical documentation for proper ICD-10-CM/CPT-4 code assignment and prepare claims Seek clinical documentation and make coding recommendations to physicians Provide physician training on MRA/HEDIS coding and documentation guidelines Ensure medical records accuracy and completion through pre- and post-audit processes Complete 30 medical record abstracts daily and provide coding recommendations Provide PCP MRA/HEDIS coding support, education, and training Monitor coding changes and ensure up-to-date information Assist with chart reviews/audits performed by health plans Identify problem areas and trends Work HCC/HEDIS Care Gap Reports Maintain up-to-date knowledge of coding innovations to improve workflow Reconcile and complete PCP coding recommendations and Level 1 claim corrections Perform other duties as assigned QUALIFICATIONS / EDUCATION High School Diploma or equivalent required CPC & ICD10 Certification required Minimum of 3 years of medical coding experience with progressive responsibility preferred Proficient in official coding guidelines, ICD-10-CM, CPT-4, and HCPCS CERTIFICATIONS / LICENSES CPC & ICD10 Certification required WORK ENVIRONMENT Moderate to high noise level Clean, well-lit, comfortable climate Fast-paced environment Reasonable accommodations may be made for individuals with disabilities SENIORITY LEVEL Mid-Senior level EMPLOYMENT TYPE Full-time JOB FUNCTION Health Care Provider INDUSTRIES Hospitals and Health Care #J-18808-Ljbffr Claremedica

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