| Employer: | Insperity Client |
| Type: | FULL TIME |
| Job Location: | Remote |
| Required Certifications: | CCS,CRC,CPC |
| Required Experience: | 3 to 4 years |
| Location: | Houston 77001, TX, US* Note: This listing is for a remote position |
| Date Posted: | 1/15/2021 |
Our
client is a San Antonio based virtual organization committed to be the provider
of choice for health plans and pharmacy organizations seeking non-financial
auditing, compliance, or consulting services. We currently serve over 150
organizations nationally and are experiencing steady growth because of our commitment
to superior client service.
Our
client’s success is fueled by their exceptional employees assisting small to
large size organizations to attain compliance through our superior knowledge,
outstanding client service, consistent delivery and solution-focused attributes.
Fortitude and flexibility are required. We seek talented, high-energy
professionals who have the stamina, drive and passion to work for a small
growing company.
Medical Record Coder – Remote
As
the Medical Record Coder, you’ll conduct audits of health status by performing
primary source validation comparison of medical record documentation to the
corresponding paid claim to ensure all risk adjusted diagnosis in the medical
record and on the claim align and originate from a valid source.
The
Medical Record Coder is a temporary position reporting to a Manager and is
classified as nonexempt.
Responsibilities:
- Performs quality reviews on records to
validate coding according to the International Classification of Diseases
Manual (ICD-10) for diagnoses and coding guidelines
- Reviews medical records to validate
diagnosis on the claim are supported by the medical record documentation
- Reviews medical records to ensure all
relevant diagnosis for a date of service were documented by the provider
on the corresponding claim
- Works individually and/or within a
team to validate the health status which determines the risk score and HCC
for health plan members including:
- Service Code Accuracy (CPT/HCPCS)
- Diagnosis Codes Accuracy for codes
impacting risk scores
- Conditions Active and/or are Under
Current Treatment
- No Conditions were Missed (i.e.
identify chronic and acute conditions that were not captured)
- Maintains knowledge of current and
required coding certifications as appropriate; performs complex and
difficult coding and abstraction work
- Stays informed about transaction code
sets and Health Insurance Portability and Accountability Act (HIPAA)
requirements
- Demonstrates and maintains competency
in the use of computer applications
- Adheres to all company policies and
procedures, with a heightened emphasis on IT security and management
policies
Qualifications:
- Professional Coding Certification,
specifically CPC, CCS or similar required
- Certified Risk Coder (CRC) or other
coding certification(s) desired
- At least 4 years of medical coding
experience required
- HCC experience strongly desired
- Working knowledge of Microsoft Outlook
and the Microsoft Office Suite
- Ability to quickly learn new systems
with hands-on training
Benefits:
Our
client values their employees’ time and efforts. Their commitment to your
success is enhanced by their competitive compensation and an extensive benefits
package.
Plus,
they work to maintain the best possible environment for their employees, where
people can learn and grow with the company. They strive to provide a
collaborative environment where each person feels encouraged to contribute to their
processes, decisions, planning and culture.
This position is not
eligible to be performed in Colorado.
We are an equal
opportunity employer, and all qualified applicants will receive consideration
for employment without regard to race, color, religion, sex, national origin,
disability status, protected veteran status, or any other characteristic protected
by law.