Coder HCC

Omega Healthcare Management Services Pvt. Ltd.; Boca Raton, Northern (FL, KY); Hybrid; USD 65,000 - 95,000; Full time

Benefits offered by this job

Health, dental, vision coverage

401(k) with employer match

Paid time off & holidays

Bonus programs or incentives

Job summary

Omega Healthcare Management Services is seeking a Coder HCC in Boca Raton, FL to review medical records and code diagnoses, procedures, DRG/APC and charges. You will ensure accurate coding for reimbursement and quality reporting while maintaining HIPAA compliance.

The role requires CPC/CCS/RHIT/RHIA/CRC or equivalent, with at least 2 years of risk adjustment, 3M and Epic experience. Competitive benefits and a dynamic team are offered.

Qualifications

• Certified Professional Coder CPC, CCS, RHIT, RHIA, CRC or equivalent credential required.
• Minimum of 2 years of recent credentialed Risk Adjustment experience.
• Minimum of 2 years of 3M experience.
• Minimum of 2 years of Epic experience.

Responsibilities

• Abstract and code inpatient, outpatient, ED, pro fee and clinical records.
• Assign correct principal/secondary diagnoses and principal/secondary procedures with proper sequencing.
• Utilize DRG/APC reimbursement expertise to assign codes.
• Enter codes into multiple systems and encoders for clients.
• Track and document productivity and maintain 95% quality rating.
• Comply with HIPAA and regulatory requirements.

Skills

Pro-Fee - HCC

Microsoft Excel

3M Systems

Epic

Education

Certified Professional Coder CPC / CCS / RHIT / RHIA / CRC or equivalent

Job description

Summary/Objective
Under limited supervision the Coder HCC reviews medical records and performs coding on all diagnoses, procedures, DRG/APC and charge codes. The Coder HCC uses the most accurate codes for reimbursement purposes, research, epidemiology, statistical analysis outcomes, financial and strategic planning, evaluation of quality of care, and communication to support the patient’s treatment. The Coder HCC will be charged with maintaining the confidentiality of patient records and procedures.

Essential Job Functions

Responsible for abstracting, coding, sequencing and interpreting the clinical information from inpatient, outpatient, emergency department, pro fee and clinical medical records.

Responsible for the assignment of correct principal diagnoses, secondary diagnoses and principal procedure and secondary procedure codes with attention to accurate sequencing.

Utilizes technical coding principals and DRG/APC reimbursement expertise to assign appropriate codes.

Abstracts and codes pertinent medical data into multiple software programs and/or encoders. Follows official coding guidelines to review and analyze health records.

Maintains compliance with both external regulatory and accreditation requirements, and with State and Federal regulations.

Extracts pertinent data from the patient’s health record, and determines appropriate coding for reports and billing documents.

Identifies codes for reporting medical services, procedures performed by physicians. Enters codes into various computer systems dependent upon the various clients.

Track and document productivity in specified systems, maintain productivity levels as defined by the client.

Maintain 95% quality rating

Perform duties in compliance with Company’s policies and procedures, including but not limited to those related to HIPAA and compliance.

Key Success Indicators/Attributes

Ability to prioritize and multi-task in a fast-paced, changing environment.

Demonstrate ability to work in all work types and specialties.

Demonstrate ability to self-motivate, set goals, and meet deadlines.

Demonstrate leadership, mentoring, and interpersonal skills.

Demonstrate excellent presentation, verbal and written communication skills.

Ability to develop and maintain relationships with key business partners by building personal credibility and trust.

Maintain courteous and professional working relationships with employees at all levels of the organization.

Demonstrate excellent analytical, critical thinking and problem solving skills.

Skill in operating a personal computer and utilizing a variety of software applications.

Knowledge of coding convention and rules established by the AHIMA, American Medical Association (AMA), the American Hospital Association (AHA) and the Center for Medicare and Medicaid (CMS), for assignment of diagnostic and surgical procedural codes.

Knowledge of JCAHO, coding compliance and HIPAA HITECH standards affecting medical records and the impact on reimbursement and accreditation.

Qualifications

• Certified Professional Coder CPC, CCS, RHIT, RHIA, CRC, or equivalent coding credential required.
• Minimum of2 years of recent, credentialed Risk Adjustment experience
• Minimum of2 years of 3M experience
• Minimum of2 years of Epic experience

Required Skills

• Pro-Fee - HCC
• System - Microsoft - Excel
• Systems - 3M
• Systems - Epic

About Us

Founded in 2003, Omega Healthcare Management Services® (Omega Healthcare) empowers healthcare to thrive via intelligent solutions that optimize revenue cycle operations, administrative workflows, care coordination, and clinical research on a global scale. The company works with providers, payers, life science companies, medical device manufacturers, health technology firms, researchers, and industry partners to amplify teams with robust technology, specialty expertise, and operational support. Omega Healthcare serves more than 350 healthcare organizations with 35,000 skilled workers in the United States, India, Colombia, and the Philippines. For more information, visitwww.omegahms.com

We offer a comprehensive benefits package that may include health, dental, and vision coverage, voluntary insurance options, a 401(k) plan with employer match, professional development opportunities, paid time off, and holiday pay. Eligible employees may also have the opportunity to participate in bonus programs, commissions, or other variable incentive plans. Benefits and incentive eligibility may vary based on position, location, and tenure.

AAP/EEO Statement

Omega Healthcare is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, gender, age, sexual orientation, gender identity or expression, marital status, mental or physical disability, protected veteran status, and genetic information, or any other basis protected by applicable law. Omega Healthcarealso prohibits harassment of applicants or employees based on any of these protected categories.

Omega Healthcare makes reasonable accommodations when needed for applicants and candidates with disabilities or religious observances. If reasonable accommodation is needed to participate in the job application, interview, or any other part of the hiring process, please contact Human Resources [e-mail] .