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POSITION OVERVIEWThe Coding Manager is responsible for driving consistency across IPM, related to medical record documentation and the correct use of CPT-4 and ICD-10 codes to ensure adherence to established Government and third-party billing guidelines, AMA, AAP, CMS, and coding policies.
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This job will deliver value to the Health Plan, and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and Affordable Care Act (ACA), using skills including but not limited to Hierarchical Condition Category (HCC) Coding, medical coding, clinical terminology and anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment Data Validation (RADV) Audits.
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In an acute care setting doing inpatient, requires Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) or Certified Coding Specialist-Physician (CCS-P) or Registered Health Information Technologist (RHIT) or Registered Health Information Administration (RHIA) in an active status with the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC.
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The Care New England - Systems Clinical Documentation Integrity (CDI) and Coding Director collaborates with physicians, nurses, case managers, chief financial officers, and others. Requirements: Certified Coding Specialist (CCS) required with Certified Professional Coding (CPC) also preferred Certified Clinical Documentation Specialist (CCDS) preferred CDI preferred Experience Minimum 7 Years Education: Bachelor's Degree Required Schedule: on site/hybrid required Excellent oral and written skills required.
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Required Certifications, Registrations, Licenses Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), Certified Inpatient Coder (CIC) or other approved coding credential.
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One of the following Coding Certifications within 1 year of hire required: RHIA, RHIT, CCS, CIC, CCDS or CPC. Expert knowledge of ICD -10-CM coding including but not limited to; expert knowledge of principal diagnosis selection, complications/comorbidities (CCs) and major complications/comorbidities (MCCs), and conditions that impact severity of illness (SOI) and risk of mortality (ROM.
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In-depth knowledge of risk adjustment coding methodologies, including HCC (Hierarchical Condition Category) coding. Responsible for reviewing and analyzing medical records, assessing the accuracy of diagnostic coding, and identifying opportunities for improvement in risk adjustment documentation and coding practices.
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Our Certified Medical Billing and Coding Specialist program is completely self-paced, so it can be done around YOUR schedule. Have you thought about becoming a certified medical billing and coding specialist but it’s just too expensive at the $1000-$50,000 cost, it takes WAY too long to finish, AND all without any assistance in actually finding work.
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Audit all RAPS submissions to ensure accuracy in the data provided to CMS. Provide coding expertise as well as administrative oversight to ensure successful integration of AHC's HCC initiatives.
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Must live in TX, AR, FL or WI Primary Purpose The primary purpose of the Coding Specialist II is to code and verify charge data necessary to ensure correct coding, abstracting, and billing on emergency department (ED), same day surgery (SDS), outpatient clinic (OPC), observation (OBS), specialty clinics and/or inpatient OB/newborn encounters.
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Requires Certified Coding Specialist (CCS) or Certified Outpatient Coder (COC) or Certified Professional Coder (CPC) or Registered Health Information Technologist (RHIT) or Registered Health Information Administration (RHIA) or other appropriate coding certification in an active status with the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC.
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Maintains updated knowledge of all billing, coding, insurance, and compliance guidelines, including but not limited to HiPAA, CPT, ICD-10, HCHPCS, medical terminology, etc. Reports to PFS Manager of Coding Policy and Education.
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Job Description: Roles and Responsibilities: Hardware development steps including concept, architecture, part selection, schematic/layout, bring-up, FPGA coding, Python coding, validation, and documentation.
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We are seeking a qualified medical billing and coding specialist. Proven experience in medical billing and coding, with a strong understanding of ICD-10 coding guidelines and procedures.
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Requirements:Coding certification required through AHIMA or AAPC (at least one of the below):Certified Professional Coder (CPC)Certified Risk Adjustment Coder (CRC)Certified Coding Specialist for Providers (CCS-P)Registered Health Information Management Technician (RHIT)5+ years of risk adjustment coding experience, 3+ national Medicare Advantage health plan experience preferred.
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coding job Title: developer Company: Experis
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