
Chief Coding Specialist
2 days ago
Job Overview
We are seeking a skilled Medical Coder to join our team. The successful candidate will be responsible for reviewing clinical documentation, assigning accurate diagnosis and procedure codes using ICD-10-CM and CPT guidelines, and conducting risk adjustment/HCC coding.
Key Responsibilities:- Review and assign accurate diagnosis and procedure codes using ICD-10-CM and CPT guidelines.
- Conduct risk adjustment/HCC coding to identify and code chronic conditions accurately.
- Perform chart audits to evaluate documentation insufficiencies and ensure they support code assignments.
- Maintain compliance with payer and regulatory guidelines.
- Resolve queries with providers when medical records are unclear or missing details.
- Maintain productivity and accuracy targets.
- Stay updated with industry regulations, payer policies, and coding certification requirements.
- Participate in ongoing training and process improvement initiatives.
Required Skills and Qualifications:
- Certification: CPC and/or CRC from recognized bodies.
- Educational Qualification: Graduate degree preferably in Life Sciences.
- Experience: Typically 1-3 years coding experience in healthcare/risk adjustment/HCC coding.
- Strong knowledge of medical terminology and anatomy & physiology.
- Proficiency with ICD-10-CM, CPT, and other coding systems.
- Good analytical skills, attention to detail, ability to work under deadlines.
- Experience with payer policies, Medicare Advantage, Medicaid, RADV audits.
- Prior experience in facility setting (inpatient/outpatient) coding, or surgery/pathology specialties.
- Familiarity with coding compliance, appeals/denials handling.
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