Molina Healthcare is a Fortune 500 managed care company with a storied history that dates back to 1980 and the opening of a medical clinic by Dr. C. David Molina. As an employer, M
Certified Coder (Risk Adjustment Experience Required)
Location
United States
Posted
2 days ago
Salary
$20 - $39 / hour
Seniority
Mid Level
No structured requirement data.
Job Description
Certified Coder (Risk Adjustment Experience Required)
Molina Healthcare
Role Description Provides support for medical coding activities, including ensuring that ICD-10 and CPT codes are reported accurately to maintain compliance, and minimize risk and denials. Contributes to overarching strategy to provide quality and cost-effective member care. - Performs on-going member medical chart reviews. Abstracts and reports ICD-10 and CPT diagnosis codes accurately and in compliance with established coding and billing principles - minimizing risk and denials. - Demonstrates understanding of current provider office billing practices - ensuring that diagnosis and CPT codes are submitted accurately. - Documents results/findings from chart reviews and provides feedback to leadership, providers and office staff. - Provides training and education to provider network regarding risk adjustment and coding updates related to risk adjustment. - Builds positive relationships between providers and the business by providing coding assistance as needed. - Facilitates administrative duties such as planning, chart reviews scheduling, medical records procurement, provider training and education. - Assists in coordination of management activities with other departments including finance, revenue analytics, claims, encounters and enterprise/plan medical directors. - Maintains professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal networks and participating in professional societies related to medical coding in the managed care industry. Qualifications - At least 2 years medical coding experience, or equivalent combination of relevant education and experience. - Certified Professional Coder (CPC). - Certified Coding Specialist (CCS). - Latest Centers for Medicare and Medicaid Services (CMS) and American Hospital Association (AHA) clinic coding knowledge. - Ability to maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA). - Ability to effectively interface with staff, clinicians, and management. - Excellent verbal and written communication skills. - Ability to establish and maintain positive and effective work relationships with coworkers, members, providers and all other customers. - Strong verbal and written communication skills. - Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications - Certified Risk Adjustment Coder (CRC). - Certified Professional Payer – Payer (CPC-P). - Certified Coding Specialist – Physician Based (CCS-P). - Familiar with HCC (Hierarchical Condition Categories) Risk Adjustment Model. - Background in supporting risk adjustment management activities and clinical informatics. - Experience with risk adjustment data validation. Benefits Molina Healthcare offers a competitive benefits and compensation package. Company Description Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
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