You’ll need
Certifications
✓Minimum of five years experience with diagnosis coding review as a certified coder
✓One of the following credentials required: RHIA, RHIT, CPC, CCS, CCS-P
✓Certified Risk Adjustment Coder (CRC) credential
Education
✓High School Diploma or GED or Associate’s degree in a related field
✓Associate degree
Four year college degree preferred
Qualifications
✓Skill and experience in effectively collaborating with team members & others using oral, written and interpersonal communications
✓Demonstrated working knowledge of the revenue cycle process, claims processing, retrospective chart review process, compliance and federal/state regulations, CPT, ICD-9, and ICD-10 coding
✓Identify issues and formulate solutions relating to retrospective chart review process improvement initiatives
✓Understand and communicate clinical documentation requirements for correct coding and to ensure integrity of the medical record
✓PC skills in Microsoft Word and Excel
✓Organize and prioritize multiple assignments
✓Ability to deal with change and ambiguity
✓Able to work, both, as a team member or independently
Experience working with Epic preferred
About the role
This position is responsible for diagnosis coding review and vendor coding quality assurance; working to ensure that plan performance and plan revenue is based on an accurate representation of our population’s care needs and risks.