Note : Potential temp-perm so must be local to client location
Description Summary :
Accountable for accurately reviewing, interpreting, auditing, coding, and analyzing medical record documentation for diagnosis accuracy, correct documentation, and Hierarchical Coding Condition (HCC) abstraction.
Review may include inpatient, outpatient treatment and / or professional medical services, according to ICD-9 / ICD-10 CM coding guidelines and risk adjustment model regulations.
Supports Annual Commercial (ACA) and Medicare Advantage Risk Adjustment Data Validation Audits (RADV) along with the annual Risk Adjustment life cycle for the Medicare, Medicaid, and Commercial lines of business.
Responsibilities :
Understand and translate CPT, HCPC, ICD-9 / ICD-10 codes for HCC abstraction.
Review medical records for completeness, accuracy, and compliance with applicable coding guidelines and regulations.
Identify, compile, and code member / patient data using ICD-9 / ICD-10-CM and other standard classification coding systems.
Support the collection and distribution of documentation and coding improvement tools for designated practice units as applicable.
Support educational activities for internal stakeholders as necessary as subject matter expert on coding review / guidelines.
Actively participate & engage in program improvement discussions and activities.
Maintain department productivity and accuracy standards.
Qualifications :
Current Registered Health Information Technologies (RHIT) or Certified Professional Coder designation from the American Academy of Professional Coders or a Certified Coding Specialist, P from the American Health Information Management (AHIMA).
2 - 5 years of Medical Coding experience.
Minimum of 2 years’ experience in Health Insurance / quality chart audits and / or Utilization Review.
Bachelor's degree preferred.
Knowledge :
Proficiency in the CPT-4, HCPC, ICD-9 / ICD-10 coding.
Knowledge of medical terminology, medical procedures, abbreviations, and terms.
Knowledge of the healthcare delivery system.
Skills and Abilities :
Ability to utilize a personal computer and applicable software (e.g., proficiency in Word and Excel).
Effective verbal and written communication skills and the ability to work well within a team.
Demonstrate professional and ethical business practices, adherence to company standards, and a commitment to personal and professional development.
Proven ability to exercise sound judgment and problem-solving skills.
Proven ability to ask probing questions and obtain thorough and relevant information.
Create a job alert for this search
Coder • Newark, NJ, US
Related searches
Related jobs
Senior Associate - Transfer Pricing
EisnerAmper • Iselin, NJ, United States
Full-time
At EisnerAmper, we look for individuals who welcome new ideas, encourage innovation, and are eager to make an impact.Whether you're starting out in your career or taking your next step as a seasone...Show more
Last updated: 30+ days ago • Promoted
Accounting Manager
Zoetis, Inc • Parsippany, NJ, United States
Full-time
The Manager, Technical Accounting will provide technical accounting analysis and support for unique and new accounting transactions for Zoetis.
They will follow and provide updates on the standard s...Show more
Last updated: 5 hours ago • Promoted • New!
Contract Analyst
IPS-Integrated Project Services • Somerset, NJ, US
Permanent
At IPS, we are global leaders in developing innovative solutions for the consulting, architecture, engineering, project controls, procurement, construction management, and CQV of technically comple...Show more
Novartis Group Companies • East Hanover, NJ, United States
Remote
Full-time
Access and Reimbursement Manager (ARM) is a field-based role that proactively provides in person (or virtual as needed) education to defined accounts within their assigned geographies on a wide ran...Show more
Last updated: 30+ days ago • Promoted
Forex / Cryptocurrency Trader - Remote
Maverick Currencies • Newark, NJ
Remote
Full-time +1
Maverick Trading, is searching for entrepreneurially-minded, profit-driven people to be trained in the art and science of proprietary trading in its online crypto / foreign exchange trading division,...Show more
Last updated: 30+ days ago • Promoted
Coder
Quality Talent Group • Little Falls, New Jersey, United States
Full-time
Quick Apply
Our client is a leading force in advancing safer, smarter AI technology.Their work has been featured in.They've built a global community of expert contributors and have already paid out more th...Show more
Last updated: 9 days ago
Travel CT Tech - $2,050 to $2,291 per week in Brunswick, CT
AlliedTravelCareers • Brunswick, CT, US
Full-time
AlliedTravelCareers is working with Prime Time Healthcare to find a qualified CT Tech in Brunswick, Connecticut, 47909!.Now Hiring : Allied Healthcare CT - Brunswick, GA.
Contact us for Pay Informati...Show more
Last updated: 30+ days ago • Promoted
Internal Medicine
myMDCareers • Marlboro, New Jersey, US
Full-time
Internal Medicine physician employment in New Jersey : Marlboro NJ based practice seeks primary care physician.Looking for someone willling to worknormal office hours M-F from 9-5.Share call, mainl...Show more
Last updated: 30+ days ago • Promoted
Sr Director Rebate Invoice and Audit - Synergie Medication Collective
Blue Cross Blue Shield Association • Newark, NJ, United States
Full-time
The hiring range for this role is : .This is the lowest to highest salary we.A candidate's position within the.Note : No amount of pay is considered to be wages or compensation until such amount is ea...Show more
Last updated: 15 days ago • Promoted
Internal Medicine
Team Health • Holmdel, New Jersey, US
Full-time
Internal Medicine physician job in New Jersey : Are you a hospitalist physician with a passion for providing the highest quality of care? If so, TeamHealth needs you to join our dynamic team in Hol...Show more
Last updated: 30+ days ago • Promoted
Construction Billing & AR Specialist
Jobot • Newark, NJ, US
Full-time
HAVE CONSTRUCTION BILLING AND AR EXPERIENCE? WE NEED YOU!!.This Jobot Job is hosted by : Caitlin Pohl.Are you a fit? Easy Apply now by clicking the "Apply Now" button and sending us your resume.Sala...Show more
Last updated: 30+ days ago • Promoted
Anatomic Pathologist Needed for Locum Tenens Coverage at Facility in New Brunswick, NJ
LocumTenens • New Brunswick, New Jersey, United States
Full-time
This Job at a Glance Job Reference Id : ORD-201975-MD-NJ Title : MD Dates Needed : November 24 - June 28, FT Shift Type : Day Shift Assignment Type : Outpatient Call Required : Yes Board Certification Re...Show more
Last updated: 30+ days ago • Promoted
Remote Senior / Staff Code Review Experts - AI Trainer ($40-$125 per hour)
Mercor • Sayreville, New Jersey, US
Remote
Full-time
Mercor is partnering with a top AI research organization to evaluate and improve how coding assistants reason, act, and communicate during development workflows.
We’re seeking technically sharp expe...Show more
Last updated: 14 hours ago • Promoted • New!
Sales Counselor
Christian Health • Wyckoff, NJ, US
Full-time
We have had the privilege of caring for those in need for more than a century.Founded on the belief that everyone has the right to exceptional care, today we continue to provide quality care and se...Show more
Last updated: 30+ days ago • Promoted
Accountant II
Weichert, Realtors • Morris Plains, NJ, United States
Full-time
Weichert Workforce Mobility is hiring an Accountant II.This is a hybrid role requiring two days in the Parsippany, NJ corporate office.
The Accountant II, under general supervision, is responsible f...Show more
Last updated: 30+ days ago • Promoted
AVP - VP, Senior Underwriter Portfolio Manager-ABL Working Capital (hybrid) NY, NJ, CA
First Citizens Bank • Morristown, NJ, US
Full-time
This is a hybrid role, with the expectation that time working will regularly take place inside and outside of a company office based in New York, New Jersey, Santa Monica, California.The AVP - VP, ...Show more
Last updated: 30+ days ago • Promoted
BOARD CERTIFIED OPHTHALMOLOGIST
Consumer Product Testing Company • Fairfield, New Jersey, United States
Full-time
SEEKING A BOARD CERTIFIED OPHTHALMOLOGIST Consumer Product Testing Company (CPT) is a worldwide leader in the contract laboratory testing of cosmetics, personal care, pharmaceuticals, medical devic...Show more
Last updated: 30+ days ago • Promoted
Medical Equipment / Device Sales Representative (Associate) - New Jersey
Precision Surgical Inc. • New Brunswick, NJ, US
Full-time
About PSI : For over (30) years, Precision Surgical Inc.PSI is a network of trained professionals who collaborate to satisfy the clinical needs of healthcare partners by distributing quality medical...Show more