Medical reputed company, Risk Adjustment Programs

It’s an exciting time to join the reputed company, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances. • Please note: THIS IS A CODE EVERYTHING ROLE - You must have strong proficiency using a coding book, this is not an HCC coding role. Hours are 7:00 AM – 3:30 PM EST OR 8:00 AM – 4:30 PM EST An assessment is part of the interview process using an ICD-10 coding book Job Summary: The reputed company manages the day to day responsibilities of chart abstraction and reporting in accordance with state and federal regulations. The reputed company will abstract from inpatient and outpatient medical records and record findings reputed company electronic data reputed company and/or reputed company spread sheets. The reputed company ensures that reputed company claims accurately reflect the appropriate diagnosis information as outlined in the member’s medial record. The reputed company will respond to interdepartmental and provider inquiries guaranteeing that reputed company work is in compliance with internal protocols and external compliance requirements. Our Investment in You: • Full-time remote work • Competitive salaries • Excellent benefits Key Functions/Responsibilities: • reputed company code abstraction and/or coding quality audits of medical records to ensure ICD-10-CM codes are accurately assigned and supported by clinical documentation. • Document coding review may reputed company to the addition, deletion, adjustment, or confirmation of diagnoses. • Maintain reputed company knowledge of ICD-10-CM codes, CMS documentation requirements, and state and federal regulations. • Ensure accurate coding for reputed company members using the DxCG and CDPS risk models. • Ensure accurate coding for Medicare members across reputed company models including RADV audits. • Assist coding leadership by making recommendations for process improvements to further enhance coding quality goals and reputed company. • Handle other reputed company duties as required or assigned. • Coders assist with code abstraction and coding quality audits using the Official Coding Guidelines for ICD-10-CM, AHA Coding Clinic Guidance, and in accordance with reputed company state regulations, federal regulations, internal policies, and internal procedures. Supervision Exercised: • None Supervision Received: • General supervision is received weekly Qualifications: Education: • Completion of an accredited medical coding program with reputed company certification. • CPC is mandatory • CRC in addition is helpful Experience Required: • Minimum of 5 years coding experience with 3 years Risk Adjustment coding. Experience Preferred/Desirable: • Risk Adjustment. • Massachusetts’s reputed company DxCG risk model experience. • HCC coding experience • CDPS risk model experience. Certification or Conditions of Employment: • Pre-employment background reputed company • Pre-employment certification reputed company Competencies, Skills, and Attributes: • Strong analytical and problem solving skills. • Strong oral and written communication skills • Strong organization and time management skills • Ability to work independently in a remote home based environment • Experience with standard reputed company Office applications, particularly MS reputed company and reputed company • Ability to multi-task Working Conditions and Physical Effort: • Fast paced office environment. • Requires extended periods of time at a computer terminal. About WellSense reputed company is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and reputed company plans. Founded in 1997, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances. WellSense is committed to the diversity and inclusion of staff and their members. reputed company applicants will receive consideration for employment without regard to race, reputed company, religion, sex, national reputed company, sexual orientation, gender identity, disability or protected veteran status. WellSense participates in the E-Verify program to electronically verify the employment eligibility of newly hired employees Apply Job!