Risk Adjustment Coding Specialist supporting risk adjustment efforts through chart reviews and provider education. Estimated travel up to 75% in Inland Empire region, specifically LA or Orange County.
About the role
- Medical Coding Coordinator handling claim disputes and coding in healthcare. Utilizing technical skills to resolve coding issues and ensuring compliance with regulations.
Responsibilities
- reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery
- extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records
- analyzes, enters and manipulates database
- responds to or clarifies internal requests for medical information
- exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes and techniques
Requirements
- Coding Certification required : AAPC CPC (no Apprentice)
- Minimum of 3 years' experience as a Certified Medical Coder
- Demonstrate ability to problem-solve complex coding issues
- Experience with Medicare and Medicaid coding guidelines
- Strong data entry and attention to detail skills with the ability to manage multiple tasks in a fast-paced setting with competing priorities
- Intermediate experience with Microsoft Word and Excel, Outlook, and Teams
- Bachelor's Degree (Preferred)
- 5 or more years of experience as a Certified Medical Coder (Preferred)
- CPMA certification (Preferred)
- MS-DRG auditing or APR auditing experience (Preferred)
Benefits
- medical, dental and vision benefits
- 401(k) retirement savings plan
- paid time off
- company and personal holidays
- volunteer time off
- paid parental and caregiver leave
- short-term and long-term disability
- life insurance
- professional development & continued education
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