Job Description

We're Hiring: Sr. Medical Coder!
We are seeking an experienced and detail-oriented Sr. Medical Coder to join our healthcare team. The ideal candidate will have extensive knowledge of medical coding systems, healthcare regulations, and quality assurance processes to ensure accurate coding and compliance with industry standards.
Location: Rochester, NY
Role: Sr. Medical Coder
Responsible for reviewing medical records to abstract ICD10 codes that map to HCCs from a variety of different CMS Hierarchy models including Medicare Advantage, PACE, Commercial, and Medicaid CDPS model. In addition to abstracting diagnosis codes, the Clinical Review Specialist also audits medical records and validates entries that have been submitted to CMS.
Responsibilities
Conducts audits of medical records (paper, EMR, hybrid)
Adheres to compliance of Medicare, Medicaid, and Commercial risk adjustment guidelines with precision.
Understands, respects, and applies client specific guideline
Adheres to audit and medical record review schedules to meet client expectations and government-regulated deadlines
Regularly participates in peer review; provide and receive feedback
Ensures accurate documentation to support all audits
Assures adherence to and currency with internal and external regulatory guidelines:
CMS/HHS
DOH
HIPAA, HITECH, and Fraud Waste & Abuse
Medical coding protocols
Maintain coding credentials as required by credentialing agency
REQUIREMENTS:
Coding Certification: CPC, CCS, RHIT, or RHIA
Possess at least 5 years of experience of with ICD-9, ICD-10, CPT and HCPC coding systems
Proficiency in MS Office tools such as Word, PPT, Excel and be comfortable learning and becoming an expert on new and proprietary software
PREFERRED QUALIFICATIONS:
Have strong written and verbal communication skills, including propensity to establish and build strong relationships.
Take initiative to establish priorities, coordinate work activities and perform multiple and complex tasks while working independently and with minimal supervision in a remote setting.
Ability to consistently meet established minimum quality standards in a heavy production environment
Must be able to meet organization production and accuracy goals
CRC Certification
Documentation Improvement experience, experience in Hierarchical Condition Categories (HCC), knowledge of or experience in Medicare Advantage plans and knowledge of or experience in managed health care systems, PACE or Medicare are plusses
Ready to make an impact? Apply now and let's grow together!

Job Tags

Similar Jobs

SMS Staffing

Tote/Tanker Washer - 2ND SHIFT Job at SMS Staffing

...) Responsibilities and Duties of the Tote/Tanker Washer: Clean and dry tankers, hoses, equipment, and totes using a power washing system. Drain equipment into proper chemical waste drums. Visually inspect, manually clean, and pressure test totes as required...

AgencyCRM

Email Marketer or Copy Writer Job at AgencyCRM

**Job Title:** Email Marketer / Copywriter **Job Overview:** AgencyCRM is a fast-growing SaaS startup helping agencies manage their talents and freelancers with ease. Were looking for a creative and results-driven **Email Marketer / Copywriter** to craft compelling...

JETT Medical Staffing

Physician - Gastroenterology Job at JETT Medical Staffing

...Gastroenterology Physician for a permanent opportunity in Iowa October 2025 - ongoing Shift:24 hour beeper (offsite) call, 7a-7a EMR:Cerner IA license required or IMLC Excellent compensation and benefits For more information email, call or text:...

Flare energy services

Junior Graphic Designer Job at Flare energy services

...We are seeking a talented and creative Junior Graphic Designer to join our new creativeteam. As a Junior Graphic Designer, you will work closely with our senior designers and marketing team to create visually appealing and effective designs for various marketing materials...

US Foods

Warehouse Order Selector Job at US Foods

...CAREER SITE (Join Our Community of Food People!**JOIN OUR WAREHOUSE TEAM!**Our Night Warehouse Selectors make between **$24.51 and $31.14** an... ...You Bring to the Table**+ Able to work 8+ hour night shifts, typically Sunday - Thursday.+ _At times weekends and holidays...

Sr. Medical Coder Job at Tap Growth ai, Rochester, NY

bXVxQmZzODJsNVptbVErSFU4eEZaZ0VTaGc9PQ==