MEDICAL DIAGNOSIS CODER

DaMar Staffing; San Juan (PR); Hybrid; USD 18,000 - 23,000; Full time

Benefits offered by this job

Remote work after training

Job summary

DaMar Staffing seeks a Medical Billing Specialist to evaluate CHRA forms and code clinical information per established guidelines. You will enter diagnoses into the main system and assist with post-payment audits to verify required data.

Role requires knowledge of ICD-9/ICD-10 coding, and involves generating referrals for corrections and processing CHRA adjustments. Remote work may be possible after an initial training period.

Qualifications

• Two years of college education or 60 approved credits from an accredited university.
• One year of medical billing with ICD-9/ICD-10 coding or six months in clinical billing and coding.
• Knowledge of medical billing processes and ICD-9-CM, ICD-10-CM coding.

Responsibilities

• Evaluate CHRA forms and code clinical information per guidelines.
• Code diagnoses documented in CHRA and enter data into the application.
• Perform post-payment audits by comparing CHRA data to required information.
• Generate referrals in the unit's electronic app for corrections as needed.
• Process adjustments for CHRA corrections following guidance.
• Identify claims needing support from Claims or Providers departments.
• Provide regular audit reports to the supervisor.

Skills

Medical billing

ICD-9/10 coding

Spanish (Intermediate)

English (Intermediate)

Education

Associate's Degree or 60 college credits

Tools

ICD-9-CM

ICD-10-CM

Job description

Job Title

Responsible for evaluating CHRA (Comprehensive Health Risk Assessment) forms received from Classicare policyholders and coding the documented clinical information according to the guidelines established by the unit.

Essential Functions

• Performs coding of diagnoses documented in the CHRA (Comprehensive Health Risk Assessment) and registers the data into the appropriate application.
• Works on post-payment audits of adjudicated claims based on the information contained in the Comprehensive Health Risk Assessment comparing it to the information required, following the operational guidelines established by the unit.
• Generates referrals through the electronic app used in the Unit with providers and/or billing representatives, related to CHRA document management, to guide them and/or request correction of medical diagnoses due to incorrect coding, and inadequate, ambiguous, or incomplete medical documentation.
• Processes adjustments received for corrections in the CHRA, following the established operational guidance.
• Identifies claims that require the support of the Claims and/or Providers department to be processed.
• Provides weekly, monthly, and quarterly reports to the supervisor on audits performed as required.

Minimum Qualifications

• Two (2) years of college education equivalent to sixty (60) approved credits from an accredited university or an Associate's Degree.
• One (1) year of medical billing experience with ICD-9 and ICD10 coding or at least six (6) months of experience performing clinical billing and coding processes.
• Knowledge of medical billing processes and ICD-9-CM, ICD-10-CM coding is required.

Certifications/Licenses: Medical billing certification and/or ICD-9, ICD-10, and/or other health-related certifications preferred.

Languages:

Spanish - Intermediate (writing, conversational, comprehension, and reading)

English - Intermediate (writing, comprehension, and reading)

Job Type: Full-time, Permanent Position

Modality: After 6 months of training, the role may transition to 100% remote.

Schedule: Monday - Friday rotating schedules from 7:00am - 6:00pm, some Saturdays during high season may be required.

Compensation: $15.00rph + benefits package.

TPIS is an Equal Opportunity Employer (EEO Employer / Aff ...). We comply with all Federal, State and Local laws regarding nondiscrimination.