Medical Coding Manager

亚美医师协会CAIPA career - Care Coordinator

We are seeking a dedicated Care Coordinator to assist with the care management of our patient population. The Care Coordinator works in collaboration and continuous partnership with chronically ill and/or “high-risk” patients and their family/caregivers, clinic/hospital/specialty providers and staff, and community resources.

A medical Coding Manager will need to review medical record information to identify all appropriate coding and rectify any problem to ensure maximum reimbursement and risk adjustment.  Be able to collect health information as documented by medical specialists and code them appropriately.

  • Consult with primary care and specialist physicians for further clarification and understanding of items in patient charts to avoid any misinterpretations
  • Follow up with the physician on any documentation that is insufficient or unclear, resolve issue(s)
  • Search for information in cases where the coding is complex or unusual
  • Advocate for patients where their medical history is needed as evidence
  • Ensure codes tally with physicians’ diagnoses and the codes are in tune with the latest reimbursement policies and CMS guidelines
  • Timely update physicians with accurate coding information and recommend proper coding strategies
  • Collaborate with other departments and professionals to effectively resolve any medical coding issue that may arise
  • Evaluate and assist with re-filing appeals of patient claims that were denied due to coding error(s)
  • Communicate with insurance companies about coding errors and disputes
  • Conduct internal audits and coding reviews; assist with external audits and coding reviews
  • Provide accurate answers to inquiries on coding in a timely manner
  • Develop new or modified coding guidelines, communicate and implement them in a timely manner
  • Develop coding education materials and tools, organize and make educational presentations to physicians, clinical staff, coders and billers on proper coding, risk adjustment coding, and related topics
  • Perform assessments on medical coding related technologies and make recommendations/suggestions
  • Assist staff to develop competence in coding knowledge and skills by training, managing, and mentoring them

 

Qualifications

  • Strong knowledge and experience in medical terminology and ICDs, CPTs, HCPCS and other codes
  • Strong knowledge and experience in medical coding for outpatient and ambulatory procedures
  • Proficient in Microsoft Office applications, EHRs, other software applications, and data entry of codes
  • Certified Professional Coder, additional related certification(s) preferred.
  • References upon request

 

Benefits

  • Health Benefits: Medical, Vision and Dental
  • 401 Retirement Plan
  • Paid Vacation, Holiday and sick time

 

If interested please send resume to hr@caipa.net

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