Medical Coder
The Judge Group
Newark, New Jersey
medical
regulations
exp
abstraction
data
management
health
stakeholders
subject matter expert
expert
medical
policies & procedures
remote
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October 4, 2022
The Judge Group
Newark, New Jersey
Looking for a Risk Adjustment Coding Auditor in Newark, NJ!
*****Candidates need to live commutable to Newark, NJ.
Job Details:
- Title: Risk Adjustment Coding Auditor
- Location: Newark, NJ - The position is remote during the temp portion and hybrid (approx 2x week in office) when it goes perm
- Type of Engagement: Contract to hire
- Rate: Contract $40/hour - if hired Full Time $89,000 to $90,000
- Hours: Regular business hours
Summary:
The Senior Professional Coder provides services to perform code abstraction 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 internal procedures.
Responsibilities:
- Compile chart review findings statistics, analyze data results and implement meaningful action plans that improve providers performance levels
- Education new staff to produce and maintain high quality data abstraction and chart reviews
- Develop quality assurance processes to ensure data integrity of all submitted diagnoses to regulatory agencies and key stakeholders
- Evaluate and improve the effectiveness of risk adjustment coding programs, policies & procedures and work flow
- Work closely with inter-departmental team management to support coding initiatives related to risk adjustment programs
- As a Subject Matter Expert, this person will support risk adjustment coding initiatives to identify opportunities to enhance and grow business
- Responsible for educating and keeping management informed on current changes in regulations/guidance related to ICD-10 coding and quality documentation and reporting
- Interface with operations and clinical leadership to assist in identification of coding & documentation improvements and promote best practices
- Conduct mock audits or surveillance activities that target problematic diagnoses as identified by CMS and internal stakeholders
- Can 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.
- Maintains department productivity and accuracy standards.
Qualifications:
- Bachelor's degree required
- * Requires current Registered Health Information Technologies (RHIT) or Certified Professional Coder (AAPC) designation from the American Academy of Professional Coders or a Certified Coding Specialist, or from the American Health Information Management (AHIMA)
- Requires a minimum of 5 years of Medical Coding experience
- Requires a minimum of 5 years experience in Health Insurance/quality chart audits and/or Utilization Review
- * 3-5 years Risk Adjustment exp
- * Exp with Medicare and ACA Audits
- * Exp with RADV audits
- * HCC Coding exp
- * A subject matter expert - comfortable with presentations
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