SUMMARY The Medical Coder II position performs coding services for the organization to ensure proper reimbursement and compliance with correct coding guidelines. This individual requires skills in sequencing diagnosis/procedure codes to optimize reimbursement. ESSENTIAL DUTIES AND RESPONSIBILITIES Evaluate medical documentation for proper ICD-10-CM/CPT-4 code assignment and prepare claims Seek clinical documentation and make coding recommendations to physicians Provide physician training on MRA/HEDIS coding and documentation guidelines Ensure medical records accuracy and completion through pre- and post-audit processes Complete 30 medical record abstracts daily and provide coding recommendations Provide PCP MRA/HEDIS coding support, education, and training Monitor coding changes and ensure up-to-date information Assist with chart reviews/audits performed by health plans Identify problem areas and trends Work HCC/HEDIS Care Gap Reports Maintain up-to-date knowledge of coding innovations to improve workflow Reconcile and complete PCP coding recommendations and Level 1 claim corrections Perform other duties as assigned QUALIFICATIONS / EDUCATION High School Diploma or equivalent required CPC & ICD10 Certification required Minimum of 3 years of medical coding experience with progressive responsibility preferred Proficient in official coding guidelines, ICD-10-CM, CPT-4, and HCPCS CERTIFICATIONS / LICENSES CPC & ICD10 Certification required WORK ENVIRONMENT Moderate to high noise level Clean, well-lit, comfortable climate Fast-paced environment Reasonable accommodations may be made for individuals with disabilities SENIORITY LEVEL Mid-Senior level EMPLOYMENT TYPE Full-time JOB FUNCTION Health Care Provider INDUSTRIES Hospitals and Health Care #J-18808-Ljbffr Claremedica
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