Job Type: Medical Coding Specialist from home
Location: Texas work from home
Company: Vesta Healthcare

Responsibilities:

• Utilizing clinical, coding, and claims processing expertise, independently analyze claims both before and after payment to make sure they are tagged accurately in accordance with CPT, ICD-10, and/or risk adjustment recommendations.
• Examine relevant medical records to confirm or refute any possible problems noted on claims.
  Create and follow a personalized audit schedule by working closely with leadership and provider staff to ensure that it is reviewed as needed.
• Provide detailed documentation of all concerns found to support claim changes, including any supporting clinical, medical, or coding justifications.
• Determine and record any upstream process gaps that are causing an inaccurate payment.
• In charge of ensuring that all protected health information accessible during regular business operations is secure and private.
• uses clinical and coding knowledge to ensure that the medical record has the right documentation and that it is complete enough to meet coding criteria and be submitted with a claim.
• reports missing charges and corrects mistakes in order to submit a claim.
• finds opportunities to provide documentation training to coworkers, medical personnel, and other professionals
• Reach targets for output, accuracy of code assignments, timeliness, and consistency of documentation.
• Work together to address concerns and make sure the claim moves forward via the revenue cycle management process with the clinical team and the director of revenue cycle.
• Quickly adjust to different platforms and coding scenarios, and take pleasure in picking up new skills.

Requirements:

If you had to sum yourself up, who have you been to:

• 3+ years of experience coding ICD-10 are necessary.
• Current Certification in Professional Medical Coding (CPC, CCS, etc.) (mandatory)
• The Certified Risk Adjustment Coder (CRC) certification is mandatory.
• Certification in ICD-10 Coding (recommended)
• Knowledge of the electronic health record system eClinicalWorks (recommended)
• Medical chart auditing and quality experience, as well as experience documenting medical records, are preferred.
• Experience extracting charts for risk adjustment coding (at least one year; very recommended)
• Advanced understanding of pharmacology, anatomy and physiology, key disease processes, medical terminology, and acronyms

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