drjobs FFS & MRA Coding Specialist

FFS & MRA Coding Specialist

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1 Vacancy
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Job Location drjobs

Henderson - USA

Monthly Salary drjobs

Not Disclosed

drjobs

Salary Not Disclosed

Vacancy

1 Vacancy

Job Description

Description

At P3 Health Partners our promise is to guide our communities to better health unburden clinicians align incentives and engage patients.

We are a physician-led organization relentless in our mission to overcome all obstacles by positively disrupting the business of health care transforming it from sickness care into wellness guidance.

We are looking for aFFS and MRA Coding Specialist. If you are passionate about your work; eager to have fun; and motivated to be part of a fast-growing organization then you should consider joining our team.

Coding Specialist

Overall Purpose:

The FFS and MRA Coding Specialist conducts concurrent review of all Medicare and Medicare Advantage encounters and supports the providers by ensuring documentation supports the submission of relevant ICD-10-CM MRA/HCC E&M CPT HCPCS CAT II and Quality HEDIS/Stars code information in accordance with national coding guidelines and appropriate reimbursement requirements. This person will ensure member encounter data (services and disease conditions) is being accurately documented and relevant procedural codes and diagnosis codes are captured. The outcome will be accurate and complete capture of all relevant code sets that are supported by the clinician documentation for each encounter reviewed.

Education and Experience:

  • High school diploma or equivalent required.
  • Certified through AAPC or AHIMA (CPC CCS RHIT) along with CRC preferred or willingness to obtain
  • Experience and Knowledge of CMS FFS coding guidelines and methodologies including: AWV LCD/NCD Modifiers Quality HEDIS/Stars and billing rules
  • Experience and Knowledge of MRA HCC coding guidelines and methodologies including: ICD-10-CM CMS AHA Coding Clinic and HHS
  • 3 years of coding and audit experience and understanding of E&M CPT ICD-10-CM MRA/HCC HCPCS CAT II and Quality HEDIS/Stars
  • Advanced proficiency with Microsoft Office
  • Extensive knowledge of medical terminology and ability to research coding related questions
  • Ability to effectively and compliantly query and communicate with clinicians and clinic support staff
  • If working remotely must be able to work independently in a quiet and distraction-free environment
  • As part of the screening process all coders must take and pass a coding test (with 90% accuracy)

Knowledge Skills and Abilities:

  • Ability to work independently and collaboratively in a fast-paced team environment
  • Excellent verbal written and interpersonal communication skills
  • Dependable highly motivated team player with a great attitude
  • Possess strong organizational skills and attention to detail technically savvy self-motivated with the ability to troubleshoot and problem solve

Essential Functions:

  • Apply knowledge of CMS MRA Payor and P3 coding guidelines.
  • Medical records (notes/charts) will be assigned to review and code electronically
  • Abstract and code ICD-10-CM MRA/HCC CPT HCPCs CAT II and HEDIS/Stars codes from documentation sending queries when necessary
  • Perform ongoing analysis of medical records for appropriate coding compliance
  • Ability to research CMS and Payor rules as appropriate to determine appropriate coding and billing guidelines.
  • Research and resolution of coding projects as assigned
  • Responsible for daily production goal and quality goal of 95% accuracy
  • Attend conference calls as necessary to provide information and/or feedback
  • Other duties as assigned by supervisor/manager

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about discussed or disclosed their own pay or the pay of another employee or applicant. However employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information unless the disclosure is (a) in response to a formal complaint or charge (b) in furtherance of an investigation proceeding hearing or action including an investigation conducted by the employer or (c) consistent with the contractors legal duty to furnish information. 41 CFR 60-1.35(c)


Required Experience:

Unclear Seniority

Employment Type

Full-Time

Company Industry

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