Medical Coding Reviewer – Risk Adjustment
Location
United States
Posted
5 days ago
Salary
$28 - $34 / hour
Seniority
Mid Level
Job Description
Medical Coding Reviewer – Risk Adjustment
GuideWell Source
• Review inpatient and/or outpatient medical records to identify and assign relevant diagnosis codes using ICD-10 classification systems to ensure accuracy and compliance of risk adjustment. • Review and validate provider-submitted and/or vendor-submitted medical record documentation and ICD-10 diagnosis codes to identify and correct any inaccuracies or discrepancies to ensure accuracy and compliance of risk adjustment. • Responsible for meeting production targets while adhering to strict quality audit accuracy of 95%. • Provide non-production level support by documenting coder observations that would not otherwise be captured through the diagnosis coding. • Assist Provider Educator during audit results presentation with provider groups by answering diagnosis coding questions. • Administrative duties including updating SOPs, DTPs and other related documents. • Participating in process improvement initiatives such as but not limited to coding tool enhancements.
Job Requirements
- 2+ years related work experience
- High school diploma or GED
- Required active Certified Professional Coder from American Association of Professional Coders (CPC) and/or CCSP OR (AAPC) or American Health Information Management Association (AHIMA)
- Ability to work independently in a remote work environment.
- Proficient with ICD-10-CM Guidelines for coding and reporting.
- Previous work experience in a production-based environment.
- Strong understanding of medical terminology, abbreviations, body systems/anatomy, physiology and concepts of disease processes.
- Intermediate level of Microsoft Office proficiency (Word, Excel, Outlook, PowerPoint).
Benefits
- Medical, dental, vision, life and global travel health insurance
- Income protection benefits: life insurance, short- and long-term disability programs
- Leave programs to support personal circumstances
- Retirement Savings Plan including employer match
- Paid time off, volunteer time off, 10 holidays and 2 well-being days
- Additional voluntary benefits available; and a comprehensive wellness program
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