Medical Coding Analyst

Position Summary

The Coding Analyst will provide Risk Adjustment/HCC coding and auditing services that include the analysis and translation of medical and clinical diagnoses, procedures, injuries, or illnesses into designated alphanumerical codes. The Medical Coder will summarize audit results and provide feedback and education to the field team and providers regarding documentation needs and requirements.

Essential Position Functions/Responsibilities

• Review and interpret medical record documentation to identify pertinent diagnoses and procedures and assigns ICD-10 CM and CPT 4 codes accurately and timely to the highest level of specificity based upon physician documentation.
• Verify and ensure the accuracy and completeness of medical records while extracting appropriate and specific ICD-10 CM- CPT and Category II codes.
• Apply relevant Medical Coding Reference, Federal, State, and Professional guidelines to assign and record independent medical code determinations.
• Review coding patterns/trends and provides ongoing consultation to the field Quality/ Network Relations team regarding coding and documentation issues.
• Proactively identifies and communicates problems and opportunities; actively recommends and implements solutions or medical coding process improvements.
• Interpret coding rules and general policies in addition to determining appropriate conclusions.
• Determine valid encounters including legibility and valid signature requirements.
• Provide information or respond to questions from medical coding quality audits.
• Possess and maintain a current and comprehensive understanding of coding rules, changes, and guidelines as defined by the AMA.
• Responsible for consistently meeting established quality and productivity standards.
• Other duties relating to coding projects as assigned.

Qualification Requirements

• Skills, Knowledge, Abilities:
  • Experience working in medical coding/auditing with experience in Diagnosis coding
  • Knowledge of medical terminology including anatomy and physiology...
  • HCC and risk adjustment model experience strongly preferred
  • Strong background in ICD 10 Coding
  • Knowledge and understanding of CPT and CPT II (HCSPCS) codes
  • Intermediate level of experience with Microsoft Excel (Pivot table, building chart)
  • Strong written and verbal communication and organizational skills
  • Must present active AAPC or AHIMA membership ID #
  • Proficient with Excel and MS office products
  • Demonstrates the ability to perform in a high productivity fast-paced environment.
  • Knowledge of ICD-10 CM Guidelines and CMS Risk Adjustment Guidelines
  • Knowledge of Risk Adjustment Coding
• Training/Education:
  • High school diploma or general educational degree (GED), required
  • Associate or Bachelor degree in health care discipline, preferred
  • Coding Credentials through either AAPC or AHIMA (CCS, CCS-P, or CPC) maintained annually, required.
  • RRC or CPMA credentials, preferred
  • Proficient in navigating an electronic medical record and healthcare billing system
• Experience:
  • 3+ years’ of inpatient facility coding experience with both quality and productivity requirements
  • 3+ years’ of outpatient facility coding Auditing experience is preferred
  • 1+ year of inpatient and/or outpatient facility coding experience
  • 1+ year of auditing experience preferred
  • Knowledge of Risk Adjustment coding
  • 1 year of healthcare provider education experience

Pay

Base Compensation: $65,000 - $75,000 annually

Benefits

• Fully paid Medical & Dental employee coverage
• Robust benefits package (PTO, 401k, FSA, Tuition Reimbursement, etc.)

Equal Employment Opportunity Statement

HealthCare Partners, MSO is committed to fostering a diverse and inclusive workplace. We provide equal employment opportunities (EEO) to all employees and applicants without regard to race, color, religion, sex, national origin, age, disability, genetics, or any other protected status under federal, state, or local laws. In compliance with all applicable laws, HealthCare Partners, MSO upholds a strict non-discrimination policy in every location where we operate. This policy applies to all aspects of employment, including but not limited to recruitment, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

Department

Coding

Employment Type

This is a full time position