Clinical Coder, Full-Time, Hybrid

Central Maine Healthcare; United States; On-site; Full time

Job summary

An established industry player is seeking a dedicated Clinical Coder to join their remote team. This full-time position involves reviewing medical records for accurate coding of diagnoses and procedures, ensuring compliance with CMS guidelines. The role not only emphasizes coding accuracy but also fosters collaboration with healthcare professionals to enhance documentation practices. The organization values work-life balance and offers a comprehensive benefits package, including tuition reimbursement and wellness programs. If you are passionate about healthcare and coding, this opportunity is perfect for you.

Benefits

Robust Paid Time Off (PTO) program

Medical plan with enhanced benefits

Dental plan

Vision plan

Health Savings Account (HSA)

Basic Life insurance at no cost

Supplemental Life insurance

Long-term disability insurance

401(k) or 403(b) retirement savings plans

Tuition assistance for student loan repayment

Qualifications

• 2+ years of billing/coding experience in a medical/surgical setting.
• Knowledge of ICD-9/10-CM coding principles for HCC coding.

Responsibilities

• Review medical charts and assign correct diagnosis and procedure codes.
• Communicate with physicians to clarify diagnoses and procedures.
• Assess coding practices and suggest improvements.

Skills

ICD-9-CM Coding

ICD-10-CM Coding

CPT Coding

HCPCS Level II Coding

Billing/Coding Experience

Collaboration with Physicians

Education

Bachelor’s Degree

Certified Professional Coder (CPC)

Certified Coding Specialist (CCS)

Certified Risk Adjustment Coder (CRC)

Job description

At Central Maine Healthcare our team members are committed to providing exceptional care and experiences for our community and for each other every day.

Central Maine Healthcare is seeking a remote Clinical Coder to join our Accountable Care OrganizationTeam.

This is a full time, benefits eligible position.

Starting pay is $23.75 per hour.

The Clinical Coder will be responsible for reviewing Central Maine ACO providers’ medical record documentation to ensure use of accurate medical coding of all professional, inpatient and outpatient services, procedures, diagnoses and conditions in support of complete and accurate risk adjustment revenue for applicable ACO populations. The coder will review provider documentation of ICD-9-CM/ICD-10-CM codes to verify that coding meets both established coding standards as well as CMS Risk Adjustment guidelines. The coder will lead efforts to evaluate the HCC coding practices and provide analyses and recommendations to improve overall provider documentation and coding. The Risk Adjustment Coding Auditor will review medical records to determine if diagnostic codes (ICD-9-CM/ICD-10-CM) are accurately reflecting the provider documentation. The coder will summarize findings for internal and external parties.

Education and Experience:

• Bachelor’s Degree or combination of relevant education and experience
• Certified Professional Coder (CPC) or Certified Coding Specialist (CCS); Certified Risk Adjustment Coder (CRC) preferred
• 2+ years of billing/coding experience in a medical/surgical or facility setting
• Knowledge of diagnoses/procedures in accordance with ICD-9/10-CM coding principles for HCC coding
• Experience with CMS Medicare Advantage Risk Adjustment preferred
• Ability to work with physicians and care team staff in a collaborative manner

What It’s Like Working At CMH:

We are all about our team members growth and health. That why we prioritize work/life balance, community-based wellness initiatives and tuition reimbursement or student loan repayment for ALL of our team members.

CMH offers a robust benefits package that includes:

• Robust Paid Time Off (PTO) program
• Medical plan with enhanced Tier 1 benefits provided within the CMH system.
• Dental plan
• Vision plan
• Health Savings Account (HSA)
• Basic Life insurance at no cost
• Supplemental Life insurance
• Long-term disability insurance
• 401(k) or 403(b) retirement savings plans
• Tuition IO partnership for student loan repayment assistance and tuition assistance
• Family leave program for Parental Leaves
• Comprehensive Wellness Program

Essential Duties:

• Accurately and efficiently reviews medical charts and assigns the correct diagnosis (ICD-9/10 CM), procedure (CPT), and supply (HCPCS Level II) code for a wide variety of clinical cases and services.
• Identify, collect, assess, monitor and document claims and encounter coding information as it pertains to Clinical Condition Categories.
• Verify and ensure the accuracy, completeness, specificity and appropriateness of diagnosis codes based on services rendered.
• Review medical record information to identify all appropriate coding based on CMS HCC categories.
• Effectively communicates with physicians in order to clarify diagnoses/procedures and sequencing of diagnoses.
• Utilizes specialized coding knowledge and auditing skills to achieve established coding quantity and quality standards.
• Assesses medical coding practices and suggests areas of improvement for follow up physician training and communication.
• Performs other duties as assigned.

If you are passionate about making a difference and are looking for your next great career opportunity, we look forward to reviewing your application!