
Senior Coding Specialist
8 hours ago
Key Responsibilities:
- We review clinical documentation to assign diagnosis and procedure codes using ICD-10-CM, CPT, and HCPCS guidelines.
- Our risk adjustment/HCC coding process involves identifying and accurately coding chronic conditions.
- Chart audits are performed to evaluate documentation insufficiencies and ensure they support code assignments.
- Coded data must adhere to payer/regulatory guidelines and internal compliance standards.
- Queries with providers/authors are resolved when medical records are unclear or missing details.
- Productivity/accuracy targets must be met.
- Stay up-to-date with coding changes, industry regulations, payer policies, and certification requirements.
- Participate in ongoing training/process improvement initiatives.
- Assist in denial management, claims adjudication, revenue leakage identification, and payment integrity.
- Maintain patient data confidentiality/security (HIPAA/local laws).
- Professional certification: CPC/CRC from recognized bodies.
- Educational background: Graduate degree in Life Sciences preferred.
- Experience: 1-3 years coding experience in US healthcare/risk adjustment/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.
- Effective communication skills for interacting with providers/auditors.
- Computer skills: EHR/EMR tools, MS Office (Excel/Word), coding/auditing software.
- Experience with payer policies, Medicare Advantage, Medicaid, RADV audits.
- Prior experience in facility setting (inpatient/outpatient) coding, surgery/pathology specialties.
- Ability to mentor/train junior coders.
- Familiarity with coding compliance/appeals handling.
A career in this field offers opportunities for professional growth and development.
As a seasoned coder, you will have the chance to make a meaningful impact on patient care and outcomes.
OthersThis role requires strong organizational skills and attention to detail.
The ideal candidate will possess excellent problem-solving skills and be able to work independently.
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