[Hiring] Coder @WellSense Health Plan

Role Description

The Coder manages the day-to-day responsibilities of chart abstraction, vendor auditing, and reporting in accordance with state and federal regulations. The coder will abstract from in-patient and out-patient medical records and record findings via electronic database and/or Excel spreadsheets. The coder ensures that all claims accurately reflect the appropriate diagnosis information as outlined in the member’s medical record.

Qualifications

• Current core coding credentials through AHIMA or AAPC (RHIT, CCS, CCS-P, CPC, CIC, etc.). The AAPC CRC (Certified Risk Adjustment Coder) coding certification is highly recommended.
• Strong organizational skills.
• Technical savvy with a high level of competence in basic computer skills, Microsoft Outlook, Word, Excel, and Outlook.
• Strong written and verbal communication skills.
• Ability to work independently in a remote environment.
• Private lockable office space to ensure security of Member PHI.
• Minimum of 5 years coding experience with at least 3 of those years in Risk Adjustment coding.
• Completion of an accredited medical coding program with current unencumbered credentials.

Requirements

• Ability to code government and state models, including code everything projects.
• Maintain current knowledge of ICD-10-CM codes, CMS documentation requirements, and state and federal regulations.
• Ability to maintain a 95% accuracy rate on all coding projects.
• Coders assist with code abstraction and coding quality audits using the Official Coding Guidelines for ICD-9-CM/ICD-10-CM, AHA Coding Clinic Guidance, and in accordance with all state regulations, federal regulations, internal policies, and procedures.

Benefits

• Full-time remote work.
• Competitive salaries.
• Excellent benefits.
• Generous total compensation that includes benefits (medical, dental, vision, pharmacy), merit increases, Flexible Spending Accounts, 403(b) savings matches, paid time off, career advancement opportunities, and resources to support employee and family wellbeing.

Compensation Range

$22.36 - $32.45. This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, skills, and certifications/licensure as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. Note: This range is based on Boston-area data and is subject to modification based on geographic location.

Company Description

WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances. WellSense is committed to the diversity and inclusion of staff and their members.