
Medical Coding Specialist
3 days ago
Medical Coding Professional Job Description
">- We are seeking a detail-oriented and analytical Medical Coding Professional to join our team. In this role, you will be responsible for reviewing clinical documentation and assigning appropriate diagnosis and procedure codes using ICD-10-CM, CPT (and HCPCS if applicable) guidelines.
- You will conduct Risk Adjustment/HCC coding to identify and accurately code chronic conditions.
- Additionally, you will perform chart audits to evaluate documentation insufficiencies and ensure they support code assignments.
- You will ensure coded data adhere to payer/regulatory guidelines and internal compliance standards.
- Moreover, you will resolve queries with providers or documentation authors when medical records are unclear or missing needed details.
- Maintaining productivity and accuracy targets as set by the team/project is also an essential aspect of this role.
- You will stay updated with coding changes, industry regulations, payer policies, and coding certification requirements.
- Participating in ongoing training and process improvement initiatives is crucial for your success in this position.
- Furthermore, you may assist in denial management, claims adjudication, revenue leakage identification, and support payment integrity (if applicable).
- Maintaining confidentiality and security of patient data is paramount.
Required Skills and Qualifications
">- Certification: CPC (Certified Professional Coder) and/or CRC (Certified Risk Adjustment Coder)
- Educational Qualification: Graduate degree preferably in Life Sciences
- Experience: Typically 1-3 years coding experience in U.S. healthcare/risk adjustment/HCC/multispecialty coding
- Strong knowledge of medical terminology, anatomy & physiology
- Proficiency with ICD-10-CM, CPT, HCPCS, and other coding systems
- Good analytical skills, attention to detail, ability to work under deadlines
- Communication skills: both written and verbal
- Computer skills: comfortable using EHR/EMR tools, basic MS Office (Excel, Word), coding/auditing software
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