Role Description At Memorial Sloan Kettering (MSK), mission-driven teams support world-class cancer care, research, and education. This inpatient-focused Medical Coding Specialist role ensures the integrity of clinical data by translating complex hospital documentation into accurate, compliant coding that supports reimbursement, quality reporting, and regulatory requirements across inpatient services. - Analyze inpatient medical records to extract comprehensive clinical, pathologic, and procedural data - Assign and sequence ICD-10-CM diagnoses and ICD-10-PCS procedures with highest specificity - Determine and accurately apply Present on Admission (POA) indicators for all applicable diagnoses - Review admission, discharge, and concurrent documentation to validate coding completeness and accuracy - Collaborate with clinical teams and query providers when documentation clarification is required - Ensure compliance with federal, state, and payer-specific inpatient coding and reporting guidelines - Support accurate MS-DRG assignment and reimbursement through thorough coding practices - Maintain integrity of coded data for quality reporting, research, and regulatory submissions - Meet productivity benchmarks while maintaining high-quality standards across assigned inpatient cases Qualifications - 2+ years of inpatient hospital coding experience required - Advanced knowledge of ICD-10-CM, ICD-10-PCS, MS-DRG methodology, and POA reporting guidelines - Strong understanding of anatomy, physiology, and complex disease processes, especially oncology - Experience with Epic, 3M/Solventum Encoder, or similar inpatient coding systems preferred - CPC, CCS, or equivalent AHIMA/AAPC inpatient coding certification required - Demonstrated ability to maintain confidentiality of protected health information Requirements - Exceptional attention to detail with a focus on coding accuracy and compliance - Strong analytical and critical-thinking skills for complex inpatient case review - Effective communication skills for provider queries and interdisciplinary collaboration - Ability to manage high-volume workloads while meeting deadlines and quality metrics - Sound professional judgment within a highly regulated inpatient coding environment Benefits - Flexible start between 6 AM – 10 AM EST - Remote location - Pay Range: $32.10 - $49.79 - FSLA Status: Non-Exempt

Role Description The coder is a key member of the health information team. The coder will work under the direction of the Manager of Coding. The coding position will be responsible for accurate review of charges and coding of Amberwell accounts. - Able to work as a member of a team and also independently. - Understand and follow safe work practices. - Ensure that all Amberwell procedures are followed in accordance with established policies. - Chart review for completion before coding. - Review of all charges on account and entry of missing charges. - Abstracting and coding of all records according to established guidelines. - Accurately assigns DRGs for inpatient records and CPT codes for outpatient records. Qualifications - Minimum Required Experience: 1 year in medical coding. - Preferred Experience: 2+ years. - Minimum Required Education: Vocational/Technical degree. - Minimum Required Licenses: N/A. - Minimum Required Certification: Coding Certificate. - Preferred Certifications: CCS, CCS-P. Benefits - Professional environment that values consistency and collaboration. - Focus on patient-first decision making. - Regular appreciation events and activities for employees.

Role Description The coder is a key member of the health information team. The coder will work under the direction of the Manager of Coding. The coding position will be responsible for accurate review of charges and coding of Amberwell accounts. - Able to work as a member of a team and also independently. - Understand and follow safe work practices. - Ensure that all Amberwell procedures are followed in accordance with established policies. - Chart review for completion before coding. - Review of all charges on account and entry of missing charges. - Abstracting and coding of all records according to established guidelines. - Accurately assigns DRGs for inpatient records and CPT codes for outpatient records. Qualifications - Minimum Required Experience: 1 year in medical coding. - Preferred Experience: 2+ years. - Minimum Required Education: Vocational/Technical degree. - Minimum Required Licenses: N/A. - Minimum Required Certification: Coding Certificate. - Preferred Certifications: CCS, CCS-P. Benefits - Professional environment that values consistency and collaboration. - Focus on patient-first decision making. - Servant leadership is both modeled and mentored. - Regular appreciation events and activities for employees.

Role Description Under the direction of the Supervisor, Risk Adjustment Coding and Outreach, this position will be responsible for the ICD-10-CM diagnosis code capture for Affordable Care Act (ACA) and Medicare Risk Adjustment initiatives to include CMS required Medicare and Commercial Risk Adjustment and Risk Adjustment Data Validation (RADV) audits. The responsibilities of this position significantly impact the company's risk adjustment revenue opportunities. This position will retrieve, review, and analyze medical records for documentation to substantiate the medical diagnosis codes submitted on claims. Activities also include member and provider communication and education, scheduling, and process performance measurement to support closing both risk adjustment and quality care gaps. This position is in a fast-paced, developing area. This position is eligible to work remote, hybrid or onsite in accordance with our Telecommuting Policy. Applicants must reside in Kansas or Missouri or be willing to relocate as a condition of employment. What you’ll do - Ensures compliance with all applicable Federal laws and regulations related to coding and documentation guidelines for Commercial and Medicare Risk Adjustment Payment System. - Performs medical record review to capture all relevant diagnosis codes included in the CMS and HHS Hierarchical Condition Categories (HCC) conditions for Commercial and Medicare Risk Adjustment Payment system. - Abstract diagnostic data and properly assign ICD-10-CM codes for both health Hierarchical Condition Categories (HCC) and Rx HCCs that map to a Risk Adjusted HCC ensuring the documentation meets all CMS standard requirements for valid HCC Submission. - Selects and accurately records all appropriate records and data on assigned chart abstraction projects. - Utilize medical coding software programs to abstract, analyze, and/or evaluate clinic documentation and enter diagnosis codes. - Comply with national standards and coding practices set by the ICD-10-CM coding guidelines for accuracy, and compliance with Risk adjustment production standards. - Must meet 95% coding accuracy within 6 months and maintain accuracy in conjunction with department coding production guidelines. - Research and review provider submitted claims through Imaging resources. - Ability to learn and understand Natural Language Processing software (NLP). Qualifications - High school diploma or equivalent is required. - AAPC or AHIMA coding certification required. - Risk adjustment HCC coding experience is preferred. - One year of experience to include coding, billing, claims auditing. Requirements - Extensive knowledge of ICD-10CM coding guidelines. - Ability to consistently meet established minimum coding quality standards in a production environment. - Ability to assimilate and adapt quickly and accurately to coding guideline and/or other job-related changes. - Requires close attention to detail, strong grammar and reading comprehension skills, along with strong critical thinking and problem-solving skills. - Ability to work independently with minimum supervision, excellent reliability, and demonstrated ability to work timely and effectively under strict deadlines. - Make recommendations for process improvements to further enhance coding quality and outcomes. - Complies with policies and procedures for confidentiality of all patient records and security of systems as required by HIPAA Privacy regulations. - Responsible for continuous improvement and ensuring a high level of accuracy on internal chart audits. Compensation $27.08 - $33.80 Non-exempt Grade 13 Blue Cross and Blue Shield of Kansas offers excellent competitive compensation with the goal of retaining and growing talented team members. The compensation range for this role is a good faith estimate, it is estimated based on what a successful candidate might be paid. All offers presented to candidates are carefully reviewed to ensure fair, equitable pay by offering competitive wages that align with the individual's skills, education, experience, and training. The range may vary above or below the stated amounts. Benefits - Base compensation is only one component of your competitive Total Rewards package. - Incentive pay program (EPIP). - Health/Vision/Dental insurance. - 6 weeks paid parental leave for new mothers and fathers. - Fertility/Adoption assistance. - 2 weeks paid caregiver leave. - 401(k) plan matching up to 5%. - Tuition reimbursement. - Health & fitness benefits, discounts and resources.