Risk Adjustment Coder

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🔥 1 minute ago

🏖️ New Jersey – Remote

🏖️ New Jersey – Remote

⏰ Full Time

🟢 Junior

🏥 Medical Billing and Coding

👻 Ghost score 10%

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ExactCare

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2009

🏥 Healthcare

⚕️ Healthcare Insurance

💊 Pharmaceuticals

💰 Private Equity Round on 2016-03

Healthcare • Healthcare Insurance • Pharmaceuticals

ExactCare is a leading pharmacy care management provider that specializes in medication management for individuals with complex, chronic medical needs. With operations in all 50 states and Washington, D. C. , ExactCare supports more than 100,000 people nationwide, helping them manage their medications in assisted living, long-term care facilities, and at home. Partnering with healthcare organizations, ExactCare aims to improve clinical outcomes by ensuring better medication adherence, reducing readmissions, and lowering overall healthcare costs.

📋 Description

• Review medical records and apply coding principles to the highest specificity • Comply with CMS and HIPAA regulations, company goals, and policies • Perform quantitative and qualitative analysis of paper and electronic medical records for completeness, consistency, and accuracy • Perform risk adjustment data validations using AHA coding guidelines • Review, analyze, and code diagnostic and procedural information from medical records to determine client payments • Perform ICD-10-CM, CPT, and HCPCS coding for reimbursement • Interact with clients and co-workers to communicate value-added information, make improvements, and maintain strong partnerships • Research and stay current with coding updates • Work from a home office in a remote position • Commute to multiple site locations within the assigned territory when required • Work an average of 40 hours per week and be available outside normal business hours as needed

🎯 Requirements

• Valid Certified Coding Specialist (CCS) designation issued by the American Health Information Management Association, Certified Professional Coder (CPC) designation, Certified Professional Coder Apprentice (CPC-A) designation, or CCA designation with at least one year of coding experience • At least 6 months of experience coding ICD-10-CM • Experience with MS Word, Excel, and PowerPoint • Comfortable learning and becoming an expert on new and proprietary software • Strong written and verbal communication skills • Ability to establish and build strong relationships • Ability to establish priorities, coordinate work activities, and perform multiple and complex tasks independently with minimal supervision in a remote setting • Detail-oriented and quick to follow instructions and learn new tasks • Strong work ethic and impeccable integrity • Must be able to commute to multiple site locations within the assigned territory • May be necessary to work extended hours as needed • Must be available outside normal business hours on an ad-hoc basis • Must be eligible to work in this country • RHIA is a plus • Documentation Improvement experience, HCC experience, knowledge of or experience in Medicare Advantage plans, and knowledge of or experience in managed health care systems, PACE, or Medicare are a plus

🏖️ Benefits

• Medical, dental, and vision insurance • Flexible spending accounts • Company-paid life insurance • Short-term disability coverage • Voluntary benefits • 401(k) • Paid time off • Paid holidays • Medical, dental, and vision coverage effective the 1st of the month following date of hire • Remote work from a home office

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