Senior Risk Adjustment Coder – HCC/ICD-10 Expert

CMP01 Mount Sinai Medical Center of Florida, Inc.; Town of Florida (NY); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Health benefits

Life insurance

Long-term disability coverage

Healthcare spending accounts

Retirement plan

Paid time off

Tuition reimbursement

Employee assistance program

Wellness program

On-site housing for select positions

Job summary

Mount Sinai Medical Center seeks an experienced Medical Coder with CPC/CCS-P/CRC certification and 5+ years of coding and billing experience to support risk adjustment work. You will review records for accurate ICD-10-CM and CPT coding and collaborate with physicians to improve documentation.

Proficiency with Epic and a strong understanding of CMS risk adjustment models are essential. The role emphasizes accuracy, timely chart reviews, and ongoing credential maintenance within a collaborative

Qualifications

• Certification CPC, CCS-P or CRC required.
• Education: High School graduate.
• Five+ years of coding and billing experience.
• Knowledge of ICD-10-CM and CPT.

Responsibilities

• Demonstrates knowledge of coding and documentation standards as well as CMS risk adjustment guidelines and HCCs.
• Reviews medical records to ensure all diagnosis codes are documented for valid HCC assignment.
• Regularly reviews Epic HCC and payor CSI reports.
• Queries and educates physicians on documentation deficiencies to improve risk adjustment coding accuracy.
• Understands risk adjustment payment models and financial impact of queries.
• Uses clinical reasoning to prioritize coding efforts efficiently.
• Completes patient chart review within 24-48 hours of visit.
• Maintains active status of coding credentials and completes annual CE hours.
• Maintains professional relationships with physicians, managed care, and other departments.
• Performs other related duties.

Skills

ICD-10-CM knowledge

CPT knowledge

Medical coding experience

Epic HCC review

Education

High School diploma

Tools

Epic

Job description

Mount Sinai Medical Center seeks an experienced Medical Coder with CPC/CCS-P/CRC certification and 5+ years of coding and billing experience to support risk adjustment work. You will review records for accurate ICD-10-CM and CPT coding and collaborate with physicians to improve documentation.

Proficiency with Epic and a strong understanding of CMS risk adjustment models are essential. The role emphasizes accuracy, timely chart reviews, and ongoing credential maintenance within a collaborative