Coding Specialist / Coder
The ideal candidate for this position will be a Certified Risk Coder with health plan or acute care experience. Candidates for this position may work remotely, preferably in Utah or Arizona, but other locations may be considered.
The Coder Specialist is to perform medical record reviews and abstract highest specificity codes effectively from medical records based on the documentation provided. This data is sent to CMS to determine accurate risk adjustment factor used to adjust payments for members' future healthcare cost. Medical record reviews will be retrospective and must be conducted by a certified medical coder. Codes will be sequenced and assigned by documentation in the medical record which accurately describes each documented diagnosis. The coder is responsible for ensuring diagnosis codes selected come from a face-to-face visit with a valid risk adjustable provider. The diagnosis must be coded according to ICD version 9 or 10 depending on date of service for coding and reporting.
Completes coding quality and accuracy maintaining industry standard of 95% or better in QA audits. Communicate effectively and professionally with care provider offices, clinics, hospitals, and other clinical facilities and internal staff.
Health Choice exists to improve the health and well-being of the individuals we serve through our health plans, integrated delivery systems and managed care solutions. We strive to recruit and retain only the finest health care professionals with the highest levels of integrity, compassion and competency. If you are driven by your own personal commitment to these values and desire to work in a team-focused, collaborative and supportive environment - while still being valued for your individual strengths - Health Choice is the place for you.
Equal Opportunity Employer Minorities/Women/Veterans/Disabled
High School Diploma / GED
Certified Risk Coder (CRC) strongly preferred; CPC, CPC-I, COC, CCS, CCS-P, CPMA, or RHIT considered
At least three (3) years of coding experience
Clinical training (Medical Assistant, Registered Nurse, Licensed Practical Nurse, or Certified Nursing Assistant) preferred
College degree preferred
Knowledge of CMS and Commercial Health Plans