ICD-10: 1 year (Preferred)
Certified Professional Coder (Preferred)
Certified Coding Specialist (Preferred)
The primary function of the Coding Specialist is to assist and educate QHP providers on proper coding of all current medical conditions to the highest specificity according to Medicare requirements for the Hierarchical Condition Category (HCC) risk adjusted payment model.
Required Licensure / Certification
Job Duties & Responsibilities
Knowledge, Skills & Abilities
· Comprehensive understanding of the contents of a typical electronic medical record, medical terminology, abbreviations, ICD-9/ICD-10 coding conventions.
· Expertise in CMS Risk Adjustment Processing System (RAPS) for Medicare Advantage Plans, and medical coding, including but not limited to E/M, ICD-9 and ICD-10, CPT, and HCC coding.
· Must be confident in communication with physicians for discussion of diagnoses and risk adjustment coding.
· Proficient computer skills including Microsoft Office (Word, Outlook, Excel, PowerPoint).
· Uses independent judgment and initiative within established policies and procedures.
· Excellent communication skills, both written and verbal. Ability to change communication styles to meet the needs of the audience.
· Works effectively with others to encourage teamwork and productivity.
· Strong knowledge of healthcare and practice workflows, ideally in primary care.
· Knowledge of billing, claims, managed care.
· Knowledge of EHR systems.
· Must be able to take initiative and function independently.
· Ability to maintain confidentiality and PHI.
Job Type: Full-time
Pay: $50,000.00 - $65,000.00 per year
Work Location: One location