Certified Coder (Risk Adjustment Coding Required)

DaMar Staffing; Long Beach (CA); On-site; USD 25,000 - 54,000; Full time

Benefits offered by this job

Competitive benefits

Competitive compensation

Job summary

Molina Healthcare is seeking a skilled medical coder in Long Beach, CA to abstract ICD-10/CPT codes, review charts, and train networks on risk adjustment and coding updates.

The role emphasizes accuracy, confidentiality, and collaboration with billing and provider staff to minimize denials and compliance risk.

Qualifications

• At least 2 years medical coding experience.
• Certified Professional Coder (CPC).
• Certified Coding Specialist (CCS).
• CMS/AHA clinic coding knowledge.
• HIPAA confidentiality compliance.
• Strong verbal and written communication skills.
• Ability to interface with staff and management.
• Proficiency in Microsoft Office.

Responsibilities

• Performs ongoing member medical chart reviews and abstracts ICD-10 and CPT codes accurately to minimize risk and denials.
• Ensures coding accuracy aligned with provider office billing practices.
• Documents results and provides feedback to leadership, providers and office staff.
• Provides training on risk adjustment and coding updates for the network.
• Supports coordination of departments including finance, revenue analytics and claims.
• Maintains professional knowledge by attending workshops and reviewing relevant publications.

Skills

CPC

CCS

CMS/AHA knowledge

HIPAA compliance

Verbal & written communication

Staff coordination

Microsoft Office

Tools

Microsoft Office

Job description

JOB DESCRIPTION Job SummaryProvides support for medical coding activities, including ensuring that ICD-10 and CPT codes are reported accurately to maintain compliance, and minimize risk and denials. Contributes to overarching strategy to provide quality and cost-effective member care.

Essential Job Duties

• Performs on-going member medical chart reviews. Abstracts and reports ICD-10 and CPT diagnosis codes accurately and in compliance with established coding and billing principles - minimizing risk and denials.

• Demonstrates understanding of current provider office billing practices - ensuring that diagnosis and CPT codes are submitted accurately.

• Documents results/findings from chart reviews and provides feedback to leadership, providers and office staff.

• Provides training and education to provider network regarding risk adjustment and coding updates related to risk adjustment.

• Builds positive relationships between providers and the business by providing coding assistance as needed.

• Facilitates administrative duties such as planning, chart reviews scheduling, medical records procurement, provider training and education.

• Assists in coordination of management activities with other departments including finance, revenue analytics, claims, encounters and enterprise/plan medical directors.

• Maintains professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal networks and participating in professional societies related to medical coding in the managed care industry.

Required Qualifications- At least 2 years medical coding experience, or equivalent combination of relevant education and experience.

• Certified Professional Coder (CPC).

• Certified Coding Specialist (CCS).

• Latest Centers for Medicare and Medicaid Services (CMS) and American Hospital Association (AHA) clinic coding knowledge.

• Ability to maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).

• Ability to effectively interface with staff, clinicians, and management.

• Excellent verbal and written communication skills.

• Ability to establish and maintain positive and effective work relationships with coworkers, members, providers and all other customers.

• Strong verbal and written communication skills.

• Microsoft Office suite/applicable software program(s) proficiency.

Preferred Qualifications

• Certified Risk Adjustment Coder (CRC).

• Certified Professional Payer - Payer (CPC-P).

• Certified Coding Specialist - Physician Based (CCS-P).

• 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.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $17.85 - $38.69 / HOURLY

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.