Coding Compliance Specialist ll

BASIC FUNCTION:

Under supervision, this position is responsible for researching and analyzing the medical records when there is a discrepancy in coding; validating the coding and supporting the department in the reporting of findings. This position audits medical records to ensure compliance with the organizations coding procedures and standards according to the CMS Coding Guidelines and Official ICD10 Coding Guidelines. Reviews insurance payments and denials and recommends coding corrections to Risk Adjustment Vendors, Providers and/or CMS

JOB REQUIREMENTS:

• High School Diploma or GED.
CPC Coding Certification
• 5 years medical coding experience on Risk Adjustment coding for either Medicare Advantage or Retail Exchange business.
• Experience with process management
• PC experience and skills to include Microsoft Office
• Verbal and written communication skills
• Analytical skills
• Ability to travel 20 - 30% of the time in and out of state

PREFERRED JOB REQUIREMENTS:

• Associate or Bachelor's degree
• Experience in health insurance or health care setting

LI - POST

•CB

•CA

HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
Requirements: Expertise Government Programs, Other Job Type Full-Time Regular Location IL - Chicago, TX - Richardson, OK - Tulsa, NM - Albuquerque


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