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Clinical Quality Coder II ID-22661

About the position

This position conducts review of outpatient medical records using International Classification of Disease Coding ICD-10-CM and Current Procedural Terminology (CPT), Medicare Advantage, ICD-10-CM, and Centers for Medicare and Medicaid Services (CMS) coding and reporting guidelines. Performs medical record reviews to ensure accurate assignment of medical diagnoses and procedures. Responsible for pre-appointment review of each encounter in scope, including Medicare Advantage encounters, to ensure accurate reporting of diagnoses and to alert the physician of potential clinical conditions that may require review.

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Responsibilities

  • Conduct review of outpatient medical records using ICD-10-CM and CPT coding.
  • Perform medical record reviews to ensure accurate assignment of medical diagnoses and procedures.
  • Responsible for pre-appointment review of each encounter in scope.
  • Ensure accurate reporting of diagnoses.
  • Alert the physician of potential clinical conditions that may require review.

Requirements

  • HS Diploma or equivalent education/experience.
  • CRC-Certified Risk Adjustment Coder OR CPC-Certified Professional Coder OR AHMA OR AAPC Coding Certification (CCS-P, CPC, COC or CPC-P).
  • 1 year professional coding experience.

Nice-to-haves

  • Advanced knowledge of ICD-10 diagnosis coding conventions and requirements.
  • Knowledge of Quality Coding Program requirements such as the Medicare Advantage Coding Program/HCC.
  • Proficient use of grouper software and/or coding reference books.
  • Knowledge of National Correct Coding Initiative edits, Coding Clinic and CPT Assignment coding guidelines.
  • Ability to work independently and as part of a team.
  • Demonstrated written and verbal communications skills.

Benefits

  • Comprehensive benefits package.
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