
Healthcare Medical Coding Specialist
2 days ago
Clinical Documentation Review: We review patient medical records and assign diagnosis and procedure codes using ICD-10-CM, CPT (and HCPCS if applicable) guidelines.
Risk Adjustment / HCC Coding: Our team identifies and codes chronic conditions accurately.
Chart Audits: Evaluating documentation insufficiencies ensures they support code assignments.
Code Data Compliance: Ensuring coded data adhere to payer / regulatory guidelines and internal compliance standards.
Query Resolution: Resolving queries with providers or documentation authors when medical records are unclear or missing needed details.
Productivity and Accuracy Targets: Maintaining productivity and accuracy targets as set by the team / project.
Coding Updates: Staying updated with coding changes, industry regulations, payer policies, and coding certification requirements.
Ongoing Training and Improvement: Participating in ongoing training and process improvement initiatives.
Key Qualifications- Certification: CPC (Certified Professional Coder) and/or CRC (Certified Risk Adjustment Coder) from recognized bodies.
- Educational Qualification: Graduate degree preferably in Life Sciences.
- Experience: Typically 1-3 years coding experience in U.S. healthcare / risk adjustment / HCC / multispecialty coding.
- Knowledge and Skills: Strong knowledge of medical terminology, anatomy & physiology, proficiency with ICD-10-CM, CPT, HCPCS (if needed), and other coding systems.
- Communication and Computer Skills: 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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