Certified Coder (Risk Adjustment/Outpatient Required) - REMOTE
JOB DESCRIPTION
Job Summary
Provides support to the business by making sure proper ICD-10 and CPT codes are reported accurately to maintain compliance and to minimize risk and denials.
- KNOWLEDGE/SKILLS/ABILITIES
- Performs on-going chart reviews and abstracts diagnosis codes
- Develop an understanding of current billing practices in provider offices to ensure that diagnosis and CPT codes are submitted accordingly
- Documents results/findings from chart reviews and provides feedback to management, providers, and office staff
- Provides training and education to network of providers on how to improve their risk adjustment knowledge as well as provide coding updates related to Risk Adjustment
- Builds positive relationships between providers and Molina by providing coding assistance when necessary
- Responsible for administrative duties such as planning, scheduling of chart reviews, obtaining of medical records, and provider training and education
- Assists in coordinating management activities with other departments in Molina including Finance, Revenue analytics, Claims and Encounters, and Medical Directors
- Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies
- Contributes to team effort by accomplishing related results as needed
- Other duties as assigned
- 2 years previous coding experience
- Proficient in Microsoft Office Suite
- Ability to effectively interface with staff, clinicians, and management
- Excellent verbal and written communication skills
- Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)
- Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers, and customers
- Maintain knowledge in the latest coding guidelines (official through CMS) as well as AHA Coding Clinic guidance
JOB QUALIFICATIONS
Required Education
Associates degree or equivalent combination of education and experience
- Required License, Certification, Association
- Certified Professional Coder (CPC)
- Certified Coding Specialist (CCS)
Preferred Education
Bachelor's Degree in related field
- Preferred Experience
- Familiar with HCC (Hierarchical Condition Categories) Risk Adjustment Model
- Background in supporting risk adjustment management activities and clinical informatics
- Experience with Risk Adjustment Data Validation
- Preferred License, Certification, Association
- Certified Risk Adjustment Coder - (CRC)
- Certified Professional Payer - Payer (CPC-P)
- Certified Coding Specialist - Physician based (CCS-P)
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
- Pay Range: $21.16 - $46.42 / HOURLY
- Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Employment Type: Full Time
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