Medical Coder (Remote)
- Job Title
- Medical Coder (Remote)
- Job ID
- Houston, TX
- Other Location
Our client is a San Antonio based virtual organization committed to be the provider of choice for health plans and pharmacy organizations seeking non-financial auditing, compliance, or consulting services. We currently serve over 150 organizations nationally and are experiencing steady growth because of our commitment to superior client service.
Our client’s success is fueled by their exceptional employees assisting small to large size organizations to attain compliance through our superior knowledge, outstanding client service, consistent delivery and solution-focused attributes. Fortitude and flexibility are required. We seek talented, high-energy professionals who have the stamina, drive and passion to work for a small growing company.
Medical Record Coder – Remote
As the Medical Record Coder, you’ll conduct audits of health status by performing primary source validation comparison of medical record documentation to the corresponding paid claim to ensure all risk adjusted diagnosis in the medical record and on the claim align and originate from a valid source.
The Medical Record Coder is a temporary position reporting to a Manager and is classified as nonexempt.
- Performs quality reviews on records to validate coding according to the International Classification of Diseases Manual (ICD-10) for diagnoses and coding guidelines
- Reviews medical records to validate diagnosis on the claim are supported by the medical record documentation
- Reviews medical records to ensure all relevant diagnosis for a date of service were documented by the provider on the corresponding claim
- Works individually and/or within a team to validate the health status which determines the risk score and HCC for health plan members including:
- Service Code Accuracy (CPT/HCPCS)
- Diagnosis Codes Accuracy for codes impacting risk scores
- Conditions Active and/or are Under Current Treatment
- No Conditions were Missed (i.e. identify chronic and acute conditions that were not captured)
- Maintains knowledge of current and required coding certifications as appropriate; performs complex and difficult coding and abstraction work
- Stays informed about transaction code sets and Health Insurance Portability and Accountability Act (HIPAA) requirements
- Demonstrates and maintains competency in the use of computer applications
- Adheres to all company policies and procedures, with a heightened emphasis on IT security and management policies
- Professional Coding Certification, specifically CPC, CCS or similar required
- Certified Risk Coder (CRC) or other coding certification(s) desired
- At least 4 years of medical coding experience required
- HCC experience strongly desired
- Working knowledge of Microsoft Outlook and the Microsoft Office Suite
- Ability to quickly learn new systems with hands-on training
Our client values their employees’ time and efforts. Their commitment to your success is enhanced by their competitive compensation and an extensive benefits package.
Plus, they work to maintain the best possible environment for their employees, where people can learn and grow with the company. They strive to provide a collaborative environment where each person feels encouraged to contribute to their processes, decisions, planning and culture.
This position is not eligible to be performed in Colorado.
We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.