HCC Certified Coder

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Monogram Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2019

⚕️ Healthcare Insurance

🤝 B2B

👥 B2C

Healthcare Insurance • B2B • B2C

Monogram Health is a leading multispecialty provider that delivers in-home, evidence-based care and benefit management for patients with complex, multiple chronic conditions, with a strong focus on chronic kidney disease and related metabolic, cardiovascular, pulmonary, and behavioral health needs. The company coordinates multispecialty clinical teams (nephrology, cardiology, endocrinology, pulmonology, behavioral health, and palliative care), provides 24/7 home-based support including home dialysis and medication management, and partners with payers and physician groups to improve outcomes, reduce hospitalizations, and lower costs.

📋 Description

• Abstract clinical information and assign appropriate diagnosis and procedure codes in accordance with nationally recognized coding guidelines. • Analyze and translate medical and clinical diagnoses, in adherence with the CMS Risk Adjustment Models. • Work as a team with coding team and providers. • Audit patient health assessment, peer coding quality reviews, provider and coding team training and education. • Perform medical chart audits on prospective basis to identify, monitor and document claims and encounter coding information as it relates to Hierarchical Condition Categories (HCC). • Perform coding abstraction and medical chart quality audits to ensure clinicians have accurate clinical documentation to support ICD-10 codes and are adhering to CMS Risk Adjustment guidelines. • Educate clinicians on specific coding issues found in their charts and keep them abreast of coding and documentation guidelines. • Maintain 95% coding accuracy rate. • Maintain production goals. • Perform accurate and timely coding (CPT, ICD-9, ICD-10, HCPCS, modifiers). • Demonstrate advanced knowledge of medical terminology, anatomy, and physiology. • Provide timely correspondence with providers regarding clinical documentation opportunities and queries. • Identify trends through data analysis or chart review, reviewing existing policy for accuracy and developing new policies and recommend solutions to meet objectives. • Keep abreast of mandated regulatory, documentation and coding guidelines to documentation, including demonstrated proficiency with all areas of CPT, ICD-10 and HCPCS coding. • E/M code assignment, auditing, and education. • Perform quality audits, education, and training for coding team. • Work closely with leadership to create coding tools for coding team and providers. • Perform other duties as required or assigned.

🎯 Requirements

• CPC, CCS, or CCS-P credentials, required • CRC credentials, required • 3+ years’ experience in Certified Coder role • 3+ years’ experience in HCC coding • Experience with Athena is a plus. • Experience with medical billing is a plus. • Experience coding Nephrology is a plus. • Must have proficiency using a PC in a Windows environment, including Microsoft Word, Excel, Power Point and Electronic Medical Record • Experience communicating & working closely with Physicians • Experience in Medicare programs and regulations including fraud and abuse and Risk Adjustment • Familiar with STARs performance measures and metrics.

🏖️ Benefits

• Opportunity to work in a dynamic, fast-paced and innovative value-based provider organization that is transforming the delivery of kidney care • Competitive salary and opportunity to participate in the company’s bonus program • Comprehensive medical, dental, vision and life insurance • Flexible paid leave and vacation policy • 401(k) plan with matching contributions