Coder, Certified Professional

Location US-CA-Los Angeles
Job ID
2022-15581

Overview

Assigned codes to patient symptoms, diagnosis, operations, and treatments to process reimbursements; knowledge and expertise in reviewing and adjudicating coding services procedures and diagnoses on medical claims.  Completes accuracy and timely entry of ICD-9-CM, HCPCS procedure codes and CPT codes into the NextGen system.

Responsibilities

  1. Integrate medical coding and/or reimbursements to support accurate regulatory reporting requirements.
  2. Clarify information or diagnosis by communicating with healthcare providers.
  3. Verify medical data and/or signatures in the system and related coding accuracy.
  4. Check medical charts for accuracy and completion.
  5. Assists in quality improvement and practice management functions.
  6. Works with other department personnel on quality-related projects.
  7. Provides clerical support to Provider Workgroups, Clinical Action Teams and assists meetings as requested.
  8. Ensure and monitor completion and accuracy of physical encounter forms for all new and continuing patients.
  9. Monitor, audit and reconcile all documents required for data entry, returning incomplete or questionable documents to generating location or provider.
  10. Perform other related duties as assigned.

Qualifications

1.  A minimum of one year of college or a minimum of five years of experience as a risk adjustment coder.

2.  Prospective review of current and suspect conditions for risk adjusted population.

3.  Prepare plan for outreach for visit capture/recapture, medical record audit to ensure accuracy.

4.  Experience with EPIC eHR  

5.  Accreditation as a Certified Risk Adjustment Coder (CRC) preferred.

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