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Medical Coder III-Fully Remote-Must be a Certified Risk Coder through AAPC

The Maxis Group
Remote

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Job Details

Full-time | Contract
Up to $28 an hour
15 hours ago

Benefits

Health insurance
401(k)

Qualifications

Affordable Care Act (ACA)
Risk-based auditing
Medicare
Spreadsheets
CMS
Healthcare documentation compliance audits
CMS regulatory compliance
Retrospective medical coding audits
Health insurance knowledge
Medicare regulations
Medical record abstraction
Certified Risk Coder (CRC)
Data validation
Clinical documentation standards
Healthcare claims compliance audits
Quality data entry
Medical record review for billing accuracy
Documentation reviews

Full Job Description

Medical Coder III-Large Managed Care Company

Fully Remote

One year contract-potential for extension and/or perm hire

Up to $28 an hour/$25 plus health insurance

7-4pm or 8-5pm local time M-F. Potential for 5-10 hours a week of OT

Job Duties:

· Abstract and review inpatient and outpatient medical records for (Hierarchical Condition Categories) HCCs to determine if the HCC is supported by the medical record documentation.

· Knowledge of ICD-9 ICD10 Official Coding Guidelines, AHA Coding Clinic, including Codling clinic clarifications for DOS year under review. CMS RADV Medical Reviewer Guidance (1/10/2020).

Top Skills Required:

· Must have prior experience with CMS Contract Level Risk Adjustment Data Validation Audits (RADV) and HHS RADV audits and IPM audits.

· Must have prior vendor coding review experience.

· Must have the ability to complete chart review production requirements.

· Must be experienced in risk adjustment auditing.

· Must possess valid Certified Risk Adjustment Coder credential through AAPC.

· Must have 5+ years of risk adjustment auditing experience with a focus on CMS and HHS RADV reviews.

Must Haves:

· Must have a Certified Risk Adjustment Coder certification (CRC) through AAPC or AHIMA ·

· Will need to maintain a 95% or better coding accuracy performance ·

· Adherence to coding accuracy and productivity policy and procedure regarding diagnosis code completeness and data entry in each coding accuracy review

· Evaluate each medical record to ensure M.E.A.T. criteria support the existence of all submitted diagnosis codes ·

· Review supplied medical records to determine if diagnosis codes mapping to HCCs meet CMS and HHS documentation guidelines ·

· Must have intermediate/advanced Microsoft Excel skills ·

· Well versed in ICD-10 Official Coding Guidelines, AHA Coding Clinic and any Coding Clinic Clarifications for DOS year under review ·

· Should have prior CMS RADV contract level audit and HHS RADV coding experience.

· Should be familiar with Medicare Advantage and ACA lines of business

#ALLJ

Pay: Up to $28.00 per hour

Benefits:

401(k)
Health insurance

Experience:

RADV Auditing for Medicare/Medicaid: 5 years (Required)

License/Certification:

CRC Certified Risk Coder-AAPC (Required)

Work Location: Remote

Quick Apply

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