Medical Coder II

ClareMedica Health Partners LLC; Miami (FL); On-site; USD 60,000 - 75,000; Full time

Job summary

Claremedica Health Partners LLC is seeking an accurate Risk Adjustment Coder to join our team in a detail-oriented role focused on reviewing medical records and coding for risk adjustment models. You will verify documentation, ensure ICD-10-CM and CPT guideline adherence, and help maintain regulatory compliance across Federal and State programs.

Applicants should have CPC certification and ideally CRC certification, with 3+ years of medical coding experience and proficiency in EMR software and

Qualifications

• CPC Certification required per AAPC/AHIMA.
• CRC certification preferred.
• Minimum three years of medical coding experience.

Responsibilities

• Review medical records to identify chronic or new conditions for risk adjustment coding.
• Verify accuracy, completeness, specificity of coding per ICD-10-CM and CPT guidelines.
• Ensure compliance with Federal, State, and local regulations and Medicare guidelines.
• Produce daily coding output and collaborate with team members to meet objectives.
• Utilize EMR systems and Microsoft Office for documentation and reporting.

Skills

CPC Certification

CRC Certification (preferred)

Medical coding experience

Attention to detail

Strong computer skills

Education

High school diploma or equivalent

Bachelor’s degree in related field (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 RESPONSIBILITIES• Knowledge 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.SUPERVISORY RESPONSIBILITIES· This position does not have supervisory responsibilities.QUALIFICATIONS/REQUIREMENTS· CPC - 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.While performing the duties of this job, the employee will be required to stand, walk, sit, use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs, balance; stoop, kneel, crouch or crawl; talk or hear. The employee must occasionally lift and or move up to 15 pounds. Specific vision abilities required by the job include close vision, distance vision, peripheral vision, depth perception, and the ability to adjust your focus. Manual dexterity is required to use desktop computers and peripherals.WORK ENVIRONMENTThe work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of his job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.The noise level in the work environment is usually moderate.TRAVELOccasional local travel to the centers and attend special continuous education seminars during the business day.SAFETY HAZARD OF THE JOBMinimal Hazards