[Hiring] Medical Coding Reviewer @WebTPA

Role Description

As a Risk Adjustment Coder, you will work independently in a remote environment and collaborate with our team to ensure accuracy and quality in our diagnosis coding work. Under the direction of the Sr. Manager Risk Adjustment Audit, the Risk Adjustment Coder is responsible for reviewing medical records to apply appropriate diagnosis coding in compliance with International Classification of Diseases, Tenth Revision (ICD-10) coding guidelines for the purposes of risk adjustment.

• Review inpatient and/or outpatient medical records to identify and assign relevant diagnosis codes using ICD-10 classification systems.
• Review and validate provider-submitted and/or vendor-submitted medical record documentation and ICD-10 diagnosis codes.
• Responsible for meeting production targets while adhering to strict quality audit accuracy of 95%.
• Provide non-production level support by documenting coder observations.
• Assist Provider Educator during audit results presentation with provider groups.
• Administrative duties including updating SOPs, DTPs and other related documents.
• Participating in process improvement initiatives such as coding tool enhancements.

Qualifications

• 2+ years related work experience.
• High school diploma or GED.
• Required active Certified Professional Coder from American Association of Professional Coders (CPC) and/or CCSP OR (AAPC) or American Health Information Management Association (AHIMA).
• Ability to work independently in a remote work environment.
• Proficient with ICD-10-CM Guidelines for coding and reporting.
• Previous work experience in a production-based environment.
• Strong understanding of medical terminology, abbreviations, body systems/anatomy, physiology and concepts of disease processes.
• Intermediate level of Microsoft Office proficiency (Word, Excel, Outlook, PowerPoint).

Requirements

• CRC - Certified Risk Adjustment Coder from American Association of Professional Coders (AAPC) preferred.
• Coding or auditing experience in a Provider Group, Outpatient coding setting or Health Plan preferred.
• Knowledge of Medicare Advantage and/or Affordable Care Act (ACA-Commercial) programs preferred.
• Organizational skills, working effectively in a multi-task-based environment.
• Ability to work both independently and collaboratively.

Benefits

• Medical, dental, vision, life and global travel health insurance.
• Income protection benefits: life insurance, short- and long-term disability programs.
• Leave programs to support personal circumstances.
• Retirement Savings Plan including employer match.
• Paid time off, volunteer time off, 10 holidays and 2 well-being days.
• Additional voluntary benefits available; and a comprehensive wellness program.
• Competitive pay as well as opportunities for incentive or commission compensation.
• Regular annual reviews with pay for performance considerations for base pay increases.
• Typical Hourly Offer/Pay Range: $28 - $34.
• Hourly Pay Range: $28 - $45.