This position intended to support the achievement of the goals of the
organization and execute essential functions under the close supervision of the
Senior MRA/HEDIS Specialist and/or Director of MRA; Identify, collect, assess, monitor and document
claims and encounter coding information as it pertains to Clinical Condition
Categories. Verify and ensure the accuracy, completeness, specificity and
appropriateness of diagnosis codes based on services rendered.
Review medical record information to identify all appropriate coding based on
CMS HCC categories.
Complete appropriate paperwork/documentation/system entry regarding
Support and participate in process and quality improvement initiatives.
We help doctors perform at their best
while engaging patients in their care!
Review medical record information to identify
all appropriate coding based on CMS HCC categories
Complete appropriate paperwork/documentation/system
entry regarding claim/encounter information
Monitor coding changes to unsure that most
current information is available
Review and prepare charts for affiliates or
Work HCC suspect reports and submit to the Director
Accurately coding and submitting encounters on a
timely basis after supervisor review
Due to the nature of this position, it is
understood that coding requirements are expected to change; therefore,
participation in affiliated classes and individual efforts to maintain current
knowledge of these changes is required
Trust: Consistently models and
inspires high levels of integrity, lives up to commitments and takes
responsibility for the impact of one’s actions.
Excellence: Seeks out learning,
strives to develop and expand personally, and continuously helps others upgrade
their capability to contribute to the managed careplan.
for Results: Effectively leverages
resources to create exceptional outcomes, embraces changes and constructively
resolves barriers and constraints.
Collaborates: Engages others by gathering multiple views
and being open to diverse perspectives, focusing on a shared purpose that
places the insurance plan and medical center overall success first.
At least one of the following:
One (1) year prior medical coding and/or billing
Two (2) years prior medical assistant
CPC, CPC-A or CCS-P, CRC Coding Certification,
Pending completion of externship for coding
Familiar with Microsoft Word and Excel
Familiarity with primary care medical charts
Strong organization and process management
Strong collaboration and relationship building
High attention to detail
Excellent written and verbal communication
Ability to learn new tasks and concepts