Medical Coder

ALTA IT Services, LLC; Princeton (NJ); Remote; Full time

Job summary

ALTA IT Services, LLC is seeking a Medical Coder Representative for a contract-to-hire position to support a leading health insurance customer. This 100% remote role focuses on optimizing quality performance and enhancing member experiences through effective health plan navigation. Candidates must possess relevant coding certifications and experience in a health plan environment.

Benefits

Health and welfare benefits coverage options

Participation in a 401(k) plan

Qualifications

• 3+ years in a health plan or large provider practice.
• Certified Risk Adjustment Coder Certification required.
• Ability to navigate member benefits across product lines.

Responsibilities

• Ensure patient screening compliance with NCQA HEDIS recommendations.
• Educate patients on insurance plan navigation.
• Assist with medication refills for chronic conditions.

Skills

Knowledge of Medicare

Quality Concepts

Medical Terminology

ICD-10 coding

CPT-4 coding

Education

Bachelors Degree or Equivalent work experience

Tools

Electronic medical records

Job description

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Job Title: Medical Coder

Location: N/A, OFFSITE



Type: Contract

Compensation: $35/HR

Contractor Work Model: Remote







ALTA IT Services is staffing a contract-to-hire opportunity for a Medical Coder Representative to support a leading health insurance customer. The individual will report directly to the providers location and is responsible for carrying out the strategy to optimize quality performance while also ensuring that members have an excellent experience with their health plan. This includes maximizing both quality and risk adjustment indicators in addition to assisting members navigate their health plan benefits.



Pay $35/HR

100% Remote

Contract to hire



Must have one of the following:CPC, CPMA, COC through AAPC



Responsibilities:

• Ensure patients complete all relevant test and screenings in accordance with the NCQA HEDIS recommendations.
  
• Engage patients and shepherd them into care by scheduling appointments with their primary.
  
• Educate patients on and assist with navigating the various aspects of their insurance plan including but not limited to submitting prior authorizations, determining cost shares, obtaining referrals, checking formularies & finding in-network doctors/services.
  
• Ensure that patients have an excellent experience while in the providers office and leave in such a way that they are likely to respond positively to experience surveys.
  
• Fulfill various requests (for patients’ charts, clinical information etc.) made of the provider by the health plan that are normally handled by the providers office staff.
  
• Work with members to refill medications in a timely manner to ensure proper medication adherence to drugs used to maintain chronic conditions.
  
  
  
  Qualifications
  
  
  
  
  • Bachelors Degree or Equivalent work experience.
    
  • 3+ years of working for a health plan, in a large provider practice or some combination of bother experiences.
    
  • Knowledge of the Medicare, Commercial and Medicaid Risk Adjustment programs.
    
  • Certified Risk Adjustment Coder Certification.
    
  • Experience with electronic medical records.
    
  • Experience and strong knowledge of Quality Concepts such as HEDIS, Medication Adherence, CAHPS & HOS.
    
  • Ability to navigate member benefits across multiple product lines including Commercial, Medicaid and Medicare Advantage.
    
  • Working knowledge of medical terminology, provider reimbursement, ICD-10, HCPCS and CPT-4 coding, coordination of benefits.
    
  • Ability to handle multiple priorities and meet deadlines.
    
    
    
    
    
    System One, and its subsidiaries including Joulé, ALTA IT Services, and Mountain Ltd., are leaders in delivering outsourced services and workforce solutions across North America. We help clients get work done more efficiently and economically, without compromising quality. System One not only serves as a valued partner for our clients, but we offer eligible employees health and welfare benefits coverage options including medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as participation in a 401(k) plan.
    
    
    
    System One is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, age, national origin, disability, family care or medical leave status, genetic information, veteran status, marital status, or any other characteristic protected by applicable federal, state, or local law.
    
    
    
    #M2
    
    
    
    Ref: #855-IT Baltimore

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Contract

Job function

• Job function

  Health Care Provider

• Industries

  Staffing and Recruiting

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