Remote Risk Adjustment Medical Coder at Guidehouse

Job Family

• General Coding Travel Required: None
• Clearance Required: None
• What You Will Do: The Remote Risk Adjustment Coder must be proficient in ICD10CM Risk Adjustment coding as well as Evaluation & Management & Annual Wellness Visit Coding. Will review clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10 Diagnosis codes, along with CPT/HCPCS codes as defined for the service type, for coding, billing, internal and external reporting, research as required, and regulatory compliance. Under the direction of the coding manager/supervisor—the coder will accurately code conditions and procedures as documented and in accordance with ICD-10-CM Official Guidelines for Coding and Reporting, CMS/MAC rules and the CPT rules established by the AMA, and any other official coding guidelines established for use with mandated standard code sets. The coder scope may involve reviewing coding related denials from payers and recommending the appropriate action to resolve the claim based on payer guidelines. This position is full-time and 100% remote.

Responsibilities

Demonstrates the ability to perform quality coding of medical records. Maintains a working knowledge of ICD-10 and CPT coding principles, governmental regulations, official coding guidelines, and third-party requirements regarding documentation and billing. Assures that all services documented in the patient’s chart are coded with appropriate ICD-10 and CPT codes.

When services/diagnoses are not documented appropriately, they seek to attain proper documentation in a timely manner according to facility standards. Achieves and maintains 95% accuracy in coding while maintaining the expected level of productivity. Accuracy will be monitored during monthly reviews either within the facility.

• What You Will Need: High School Diploma or equivalent 3+ years HCC Risk Adjustment Coding. CPC or CRC certification from AAPC EMR experience Must maintain credential throughout employment Strong working knowledge & experience with Federal & State Coding regulations and
• Guidelines What Would Be Nice To Have: Ability to work independently, multi-task well and interface with all levels of personnel as well as clients Excellent verbal, written and interpersonal communication skills Basic knowledge of Excel, Word and PowerPoint High level of accuracy Previsit & Retrospective Risk Adjustment planning methodology experience Experience with CMS HCCESRD PACE, CMS HCC-RX, CDPS, CDPS-RX &/or HHS HCC CMA or LPN certification The annual salary range for this position is $44,000.00-$74,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.
• What We Offer: Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible

Benefits

• package that reflects our commitment to creating a diverse and supportive workplace.

Benefits

• include: Medical, Rx, Dental & Vision Insurance Personal and Family Sick Time & Company Paid Holidays Position may be eligible for a discretionary variable incentive bonus Parental Leave 401(k) Retirement Plan Basic Life & Supplemental Life Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts Short-Term & Long-Term Disability Tuition Reimbursement, Personal Development & Learning Opportunities Skills Development & Certifications Employee Referral Program Corporate Sponsored Events & Community Outreach Emergency Back-Up Childcare Program About Guidehouse Guidehouse is an Equal Opportunity Employer–Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.
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