Coder
United Community Health Center•Green Valley, AZ
•Onsite
About The Position
The Certified Coder is a key position responsible for abstracting medical record data and assigning/reviewing codes using current clinical classification systems. The employee will also review Medicare Risk Adjustment, understand Medicare Advantage Plans, and evaluate medical records with attention to detail.
Requirements
- Certified Coder
- Comprehensive knowledge of medical terminology, anatomy & physiology, disease processes, treatment modalities, diagnostic tests.
- Proficiency with the practice management system, appropriate to job responsibilities.
- Ability to maintain discretion when handling confidential information.
- Adherence to HIPAA rules and regulations.
Nice To Haves
- Understanding of Medicare Advantage Plans
- Experience with Medicare Risk Adjustment
Responsibilities
- Reviewing and assigning codes to diagnosis and procedures in order to ensure proper financial reimbursement from insurance companies.
- Applies comprehensive knowledge of medical terminology, anatomy & physiology, disease processes, treatment modalities, diagnostic tests.
- Assists facility staff with documentation requirements to completely and accurately reflect the patient care provided.
- Conducts claims audits/reviews, identifying opportunities for improving.
- Performing Risk Adjusted (RA) coding reviews and related analysis to optimize RA coding opportunities throughout primary care.
- Communicates with physicians and office staff regarding records needed for chart reviews related to the Risk Adjustment process.
- Serves as a Subject Matter Expert and resource in Clinical Documentation.
- Performs chart reviews for appropriateness and completeness of diagnostic codes based on CMS HCC categories.
- Collaborates in the development of coding or risk adjustment tools/training aides for contracted providers and staff.
- Ability to maintain discretion when handling confidential information. Adhere to HIPAA rules and regulations.
- Works in cooperative fashion with other team members.
- Demonstrates proficiency with the practice management system, appropriate to job responsibilities.
- Acts as liaison between Providers and Insurances Companies
- Assists staff training as needed at all levels.
- Acts as intermediary between UCHC and patients when necessary.
- Travels to UCHC clinic locations on an as needed basis
- Participates in inter-disciplinary task forces and work groups as relevant.
- Other duties as assigned.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
