Clinical Quality Coder II

🕒 September 16

🌵 Arizona, California, +21 more states – Remote

🌵 Arizona – Remote 🏄 California – Remote ⛰️ Colorado – Remote 🐊 Florida – Remote 🥔 Idaho – Remote 🌽 Illinois – Remote ⚜️ Louisiana – Remote 🦬 Montana – Remote 🎰 Nevada – Remote 🏖️ New Jersey – Remote 🌲 North Carolina – Remote 🏈 Ohio – Remote 🌲 Oregon – Remote 🚗 Michigan – Remote ❄️ Minnesota – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote 🌴 South Carolina – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⛷️ Utah – Remote ⚔️ Virginia – Remote ☕ Washington – Remote

💵 $28 - $52 / hour

⏰ Full Time

🟢 Junior

🏥 Medical Billing and Coding

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 23%

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Sutter Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded Sutter Health was founded in 1996.

🏥 Healthcare

⚕️ Healthcare Insurance

🤝 Non-profit

💰 Grant on 2016-11

Healthcare • Healthcare Insurance • Non-profit

Sutter Health is a not-for-profit health system serving Northern California, offering a wide range of healthcare services. It provides comprehensive primary and specialty care, including mental health, oncology, orthopedics, women's health, and more. The organization supports both in-person and virtual visits, ensuring accessibility to its services. Sutter Health is also involved in medical research, education, and offers various health plans, including Sutter Health Plus. It emphasizes innovative, compassionate care and maintains a network of hospitals, medical groups, and other health providers across Northern California.

📋 Description

• Conduct review of outpatient medical records using ICD-10-CM, CPT, Medicare Advantage, and CMS coding and reporting guidelines • Perform medical record reviews to ensure accurate assignment of medical diagnoses and procedures • Conduct pre-appointment review of each in-scope encounter, including Medicare Advantage encounters • Ensure accurate reporting of diagnoses • Alert physicians to potential clinical conditions that may require review • Support risk adjustment code validation for CMS and HHS Risk Adjustment models

🎯 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) • One (1) year of recent relevant experience with CMS-HCC and HHS-HCC risk adjustment coding, including review of pediatric and OB/GYN diagnoses and related documentation requirements • Advanced knowledge of ICD-10 diagnosis coding conventions and requirements • Knowledge of Medicare Advantage Coding Program/HCC and Quality Coding Program requirements • Knowledge of medical terminology and abbreviations of disease, illness and injury processes • Proficient use of grouper software and/or coding reference books to assign/validate diagnosis codes • Knowledge of National Correct Coding Initiative edits, Coding Clinic, CPT Assignment coding guidelines, and medical record contents • Ability to work independently and as part of a team while accomplishing multiple tasks in an interruption-rich environment • Demonstrated written and verbal communication skills to explain sensitive information clearly and professionally

🏖️ Benefits

• Comprehensive benefits package for eligible positions • Full-time regular employee status • Monday–Friday schedule • No weekend requirements

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