Medical Coder II

ClareMedica Health Partners, LLC; Miami (FL); On-site; USD 60,000 - 85,000; Full time

Job summary

Claremedica Health Partners, LLC in Florida seeks an accurate, detail oriented Risk Adjustment Coder to review medical records and encode encounters for Medicare risk adjustment. You will verify charts, ensure coding accuracy and maintain compliance with guidelines.

Responsibilities include coding using ICD-10-CM and CPT, identifying chronic/new conditions for validation, and meeting daily production while collaborating with the Sr. Risk Adjustment Manager and coding team.

Qualifications

• CPC certified by AAPC or AHIMA required.
• CRC certification preferred.
• 3+ years of medical coding experience.
• Strong computer skills and data entry.
• Experience with EMR systems and coding guidelines.

Responsibilities

• Review patient charts to verify accuracy and appropriate coding.
• Code office procedures according to ICD-10-CM and CPT.
• Identify chronic or new conditions for provider validation.
• Ensure compliance with federal/state regulations.
• Meet daily coding production and attend departmental meetings.
• Travel occasionally to centers and education seminars.

Skills

ICD-10-CM

CPT guidelines

Medical terminology

Anatomy & physiology

English grammar

Data entry

Microsoft Office

Education

CPC – Certified Professional Coder

CRC – Certified Risk Adjustment Coder

High school diploma or equivalent

Bachelor's degree preferred

Tools

EMR software

Microsoft Office Suite

Job description

At Claremedica, exceptional is the standard.Driven by our purpose to enhance the lives of the seniors in the communities where we have the privilege to work, live, and play, the Claremedica team is comprised of the brightest and best in their fields of expertise. From clinical excellence to unparalleled administrative support and beyond, we’re working together to help seniors live happier, healthier, fuller lives.That kind of teamwork and passion for excelling can only exist in a workplace that fosters employees’ growth and wellness and where their full potential and value are realized. At Claremedica, we’re excited about great people like you. We’re even more excited to support you with the resources, training, benefits, competitive compensation, and more to help you thrive and succeed in our communities.Opportunity awaits – welcome to Claremedica.ESSENTIAL FUNCTIONSWe are seeking an accurate, detailed oriented Risk Adjustment Coder to join our team. You will play a key role in reviewing medical records and identifying, collecting, assessing, monitoring, and documenting claims and encounter coding information for adherence to risk adjustment models. You will review and accurately code office procedures.DUTIES AND RESPONSIBILITIESKnowledge of ICD-10-CM and CPT guidelines; medical terminology; anatomy and physiology; state and federal Medicare reimbursement guidelines; English grammar and usage.Review patient’s charts to verify and ensure accuracy, completeness, specificity, and appropriate coding.Reviews medical records, patient medical history and physical exams, physician orders, progress notes, consultation reports, diagnostic reports, operative and pathology reports, and discharge summaries to identify any chronic or new conditions to be sent to providers for validation.Performs ongoing analysis of medical charts for appropriate coding compliance.Ensures compliance with all applicable Federal, State, and/or County laws and regulations related to coding and documentation guidelines.Cooperate with other personnel to achieve department objectives and maintain good employee relations, and interdepartmental objectives.Meet daily coding production.Attend departmental meetings as required.Performs additional duties assigned by the Sr. Risk Adjustment Manager or Coder Lead as needed.QUALIFICATIONS/REQUIREMENTSCPC - Certified Professional Coder; by AAPC or AHIMA plus any other coding certification.High school degree or equivalent; bachelor’s degree in related field preferred.CRC – Certified Risk Adjustment Coder, preferred.Maintain coding certification and attend in-service training as required.More than three (3) years of medical coding experience, preferably.Understanding of medical terminology, anatomy, and physiology.Strong computer skills in data entry, coding, and knowledge of Electronic Medical Record software; Microsoft Office Suite.Accurate and precise attention to detail.Ability to multitask, prioritize, and manage time efficiently.Excellent verbal and written communication skills.Goal-oriented, organized team player.WORKING CONDITIONSGeneral office working conditions.PHYSICAL DEMANDSThe physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential function.TRAVELOccasional local travel to the centers and attend special continuous education seminars during the business day.