Sr. Medical Coder

We're Hiring : Sr. Medical Coder!

We are seeking an experienced and detail-oriented Sr. Medical Coder to join our healthcare team. The ideal candidate will have extensive knowledge of medical coding systems, healthcare regulations, and quality assurance processes to ensure accurate coding and compliance with industry standards.

Location : Rochester, NY

Role : Sr. Medical Coder

Responsible for reviewing medical records to abstract ICD10 codes that map to HCCs from a  variety of different CMS Hierarchy models including Medicare Advantage, PACE, Commercial,  and Medicaid CDPS model. In addition to abstracting diagnosis codes, the Clinical Review  Specialist also audits medical records and validates entries that have been submitted to CMS.

RESPONSIBILITIES :

• Conducts audits of medical records (paper, EMR, hybrid)
• Adheres to compliance of Medicare, Medicaid, and Commercial risk adjustment guidelines with precision.
• Understands, respects, and applies client specific guideline
• Adheres to audit and medical record review schedules to meet client expectations and government-regulated deadlines
• Regularly participates in peer review; provide and receive feedback
• Ensures accurate documentation to support all audits
• Assures adherence to and currency with internal and external regulatory guidelines :
• CMS / HHS
• DOH
• HIPAA, HITECH, and Fraud Waste & Abuse
• Medical coding protocols
• Maintain coding credentials as required by credentialing agency

REQUIREMENTS :

PREFERRED QUALIFICATIONS :

Ready to make an impact? 🚀 Apply now and let's grow together!