Clinical Quality Coder II
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Job Description
Clinical Quality Coder II reviewing outpatient medical records for accurate diagnosis coding and procedure assignment. Ensuring compliance with Medicare Advantage coding guidelines and alerting physicians of potential clinical conditions.
Responsibilities:
- Conducts review of outpatient medical records using ICD-10-CM and CPT
- Performs medical record reviews to ensure accurate assignment of medical diagnoses and procedures
- Responsible for pre-appointment review of each encounter in scope
- Alerts the physician of potential clinical conditions that may require review
Requirements:
- HS Diploma or General Education Diploma (GED)
- CRC-Certified Risk Adjustment Coder OR CPC-Certified Professional Coder OR AHMA or AAPC Coding Certification (CCS-P, CPC, COC or CPC-P)
- 1 year recent relevant experience
- Advanced knowledge of ICD-10 diagnosis coding conventions and requirements
- Knowledge of Quality Coding Program requirements such as the Medicare Advantage Coding Program/HCC
- Proficient use of grouper software and/or coding reference books to assign/validate diagnosis codes
- National Correct Coding Initiative edits, Coding Clinic and CPT Assignment coding guidelines
- Ability to work independently, as well as be part of the team
- Demonstrated written and verbal communications skills
Benefits:
- Yes
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