Coder

Wellsense-Health-Plan; Massachusetts; Hybrid; USD 30,000 - 44,000; Full time

Benefits offered by this job

Full-time remote work

Competitive salaries

Excellent benefits

Job summary

WellSense Health Plan is seeking a Coder to manage chart abstraction, vendor auditing and reporting in line with state and federal regulations. You will abstract from in-patient and out-patient records and document findings in electronic databases or spreadsheets.

The role requires up-to-date ICD-10-CM knowledge, CMS guidelines, and independence in a remote environment. Minimum 5 years in coding, with at least 3 in Risk Adjustment; CPC certification is required.

Qualifications

• CPC Certification required and current credentials.
• Minimum 5 years coding experience, with at least 3 years in Risk Adjustment.
• Strong organizational and written communication skills.
• Proficient with MS Excel and MS Outlook, and able to work remotely.

Responsibilities

• Perform code abstraction and coding quality audits to ensure ICD-10-CM codes are accurately assigned and supported by clinical documentation.
• Code government and state models; manage
• Maintain current knowledge of ICD-10-CM codes, CMS requirements, and regulations.
• Maintain a 95% accuracy rate on coding projects.
• Assist with code abstraction and coding audits following Official Coding Guidelines.

Skills

CPC Certification

Remote work independence

Attention to detail

Communication skills

Risk Adjustment coding

Education

CPC Certification

Tools

Microsoft Excel

Microsoft Outlook

Job description

Job Summary:

The Coder manages the day to day responsibilities of chart abstraction, vendor auditing and reporting in accordance with state and federal regulations. The coder will abstract from in-patient and out-patient medical records and record findings via electronic data base and or excel spread sheets. The coder ensures that all claims accurately reflect the appropriate diagnosis information as outlined in the member’s medial record

Our Investment in You:

• Full-time remote work
• Competitive salaries
• Excellent benefits

Responsibilities

• Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10-CM codes are accurately assigned and supported by clinical documentation.
• Ability to code government and state models. This includes code everything projects.
• Maintain current knowledge of ICD-10-CM codes, CMS documentation requirements, and state and federal regulations.
• Ability to maintain a 95% accuracy rate on all coding projects.
• Coders assist with code abstraction and coding quality audits using the Official Coding Guidelines for ICD-9-CM/ICD-10-CM, AHA Coding Clinic Guidance, and in accordance with all state regulations, federal regulations, internal policies, and procedures.

Requirements

• Current core coding credentials through AHIMA or AAPC (RHIT, CCS, CCS-P, CPC, CIC, etc.) The AAPC CRC (Certified Risk Adjustment Coder) coding certification is highly recommended.
• Strong organizational skills
• Technical savvy with high level of competence in basic computer skills, Microsoft Outlook, Word, Excel and Outlook.
• Strong written and verbal communication skills
• Ability to work independently in a remote environment
• Private lockable office space to ensure security of Member PHI
• Minimum of 5 years coding experience with at least 3 of those years in Risk Adjustment coding.
• Completion of an accredited medical coding program with current unencumbered credentials.

Required education:

• CPC Certification

Required experience

• Risk Adjustment coding: 3 years
• Coding: 5 years

Supervision Received

• General supervision is received weekly

Compensation Range

$ 22.36- $32.45

This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, skills, and certifications/licensure as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. In addition, WellSense offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), merit increases, Flexible Spending Accounts, 403(b) savings matches, paid time off, career advancement opportunities, and resources to support employee and family wellbeing.

Note

This range is based on Boston-area data, and is subject to modification based on geographic location.

About WellSense

WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances. WellSense is committed to the diversity and inclusion of staff and their members.

Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status. WellSense participates in the E-Verify program to electronically verify the employment eligibility of newly hired employees