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Senior Coding Specialist

2 months ago

Newark, New Jersey, United States Ampcus Full time
Senior Coding Specialist - Remote Opportunity

Position Overview:
The Senior Coding Specialist is responsible for executing code abstraction in compliance with the Official Coding Guidelines for ICD9CM/ICD10CM, AHA Coding Clinic Guidance, and all relevant regulations. This role is crucial in supporting various programs, including Commercial Risk Adjustment and Medicare Advantage Risk Adjustment, ensuring a high standard of coding accuracy.

Key Responsibilities:
  • Analyze chart review findings, compile statistics, and implement actionable plans to enhance provider performance.
  • Train new team members to uphold high standards in data abstraction and chart reviews.
  • Establish quality assurance protocols to maintain the integrity of diagnoses submitted to regulatory bodies.
  • Assess and refine the effectiveness of risk adjustment coding programs and workflows.
  • Collaborate with cross-functional teams to advance coding initiatives related to risk adjustment.
  • Act as a Subject Matter Expert to identify opportunities for business growth in risk adjustment coding.
  • Keep management updated on regulatory changes affecting ICD10 coding and documentation practices.
  • Work with clinical leadership to pinpoint areas for improvement in coding and documentation.
  • Conduct audits targeting specific diagnoses as highlighted by regulatory bodies.
  • Review medical records for accuracy and compliance with coding standards.
  • Ensure departmental productivity and accuracy benchmarks are met.
Qualifications:
  • Current Registered Health Information Technologies (RHIT) or Certified Professional Coder designation is required.
  • A minimum of 5 years of experience in Medical Coding is essential.
  • 5+ years of experience in Health Insurance or quality chart audits is necessary.
  • A Bachelor's degree is mandatory.
Knowledge and Skills:
  • Proficiency in CPT4, HCPC, ICD9/ICD10 coding is required.
  • Strong understanding of medical terminology and healthcare delivery systems.
  • Ability to utilize software tools effectively, including Word and Excel.
  • Excellent verbal and written communication skills are essential.
  • Demonstrated ability to exercise sound judgment and problem-solving skills.
Disclaimer:
This job summary is intended to provide a general overview of the role and is not exhaustive of all duties and responsibilities associated with this position.