Medical Coder

The Judge Group Newark, New Jersey
medical regulations exp abstraction data management health stakeholders subject matter expert expert medical policies & procedures remote
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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