Remote Medical Coder/Auditor

Remote Medical Coder/Auditor

Certified Remote Medical Coder with demonstrated proficiency in Risk Adjustment and Hierarchical Condition Categories (HCC) in an outpatient Upgrade to see actual infodical coder performs medical chart audits for evaluation, management, and documentation. This role also interfaces and disseminates audit results to clinicians and management.

This is a full time, remote (work from home) position that requires a minimum of 30 hours a week. Work hours will be dictated by the medical group current claims workflow filing deadlines. Hours worked and schedule is subject to change.

Duties and Responsibilities:
• Daily review medical record information to identify and assign all appropriate coding (ICD–10-CMs, CPTs, and HCPCSs) based on risk adjustment models and CMS HCC categories.
• Verify and ensure the accuracy, completeness, specificity, and appropriateness of diagnosis codes based on services rendered.
• Demonstrate analytical and problem-solving ability regarding barriers to receiving and validating accurate HCC information.
• Conducts providers chart audits to identify incorrect coding, prepare reports of findings and any compliance issues.
• Reports coding patterns identified within the audit process to the Manager and identifies corrective measures to compliance problems.
• Provide support, education, and training related to, quality of documentation, level of service and diagnosis coding consistent with established coding guidelines and standards.
• Maintain a minimum 95?curacy on coding quality audits
• Maintain minimum production of 4 charts per hour
• Remain current on diagnosis coding guidelines and risk adjustment reimbursement reporting requirements.
• Maintain quality and production standards required by the medical group.
• Comply with the Standards of Ethical Coding as set forth by the American Health Information Management Association and adhere to official coding guidelines.
• Comply with HIPAA laws and regulations.
• Handle other related duties as required or assigned by the physician and practice administrator

Required skills and experience:
• Must have a minimum of GED or High School Diploma
• Must have 2+ years of Risk Adjustment, HCC coding, and Medicare Advantage reimbursement experience
• Must have 2+ years of working as a medical coder (where coding was 90% or more of your job duties, and you were held to quality and productivity goals).
• Must have strong clinical knowledge related to chronic illness diagnosis, treatment, and management;
• Must have an excellent understanding of medical terminology, disease process and anatomy, and physiology.
• Must have an excellent understanding of ICD-10-CM coding classification, CPT and HCPCS in Primary care setting.
• Must have active coding certification through AHIMA / AAPC (CRC, CPC, CCS - P). CCA, CPC-A certifications are not acceptable.
• Must have High Computer proficiency (including MS Windows, MS Office, and the Internet)
• Must have high-speed Internet access, a home computer with a current Windows operating system, MS Internet Explorer (version 6.0.2 or better), and Adobe 6.0 or better;
• Must be task-oriented, reliable and be able to meet designated deadlines and productivity standards (24-hour turnaround time on all assigned charts required).
• Must have strong Personal discipline to work remotely without direct supervision;
• Must have Knowledge of HIPAA, recognizing a commitment to privacy, security, and confidentiality of all medical chart documentation.
• Must have strong organizational skills; interpersonal and customer service skills; excellent English written and oral communication skills; and analytical skills.