Medical Coder at Advantmed

Job Title: Medical Coder
Location: Remote, US
Job Type: Full-time / Permanent
Shift Hours: Applicant should be available to work from 6 AM to 6 PM CST.
Pay Rate:  $20/hr with Benefits -  Health, Dental, Vision, Short-term and Long-term disability, Life insurance, parental leave, and more!
 
Applicants are required to possess a Windows-operated laptop/desktop with video capabilities and high-speed internet connectivity.
 
Job Summary: We are seeking experienced Medical Coders with a strong background in Risk Adjustment and Hierarchical Condition Category (HCC) coding. The ideal candidate will hold at least a CPC or CCS certification from AHIMA or AAPC, and higher-level certifications are highly desirable. As a Medical Coder specializing in Risk Adjustment/HCC, you will play a crucial role in ensuring accurate and compliant coding for our healthcare organization.
 
Key Responsibilities:

• Review and accurately code medical records and encounters for diagnoses and procedures related to Risk Adjustment and HCC coding guidelines.
• Ensure coding is consistent with ICD-10-CM, CMS-HCC, and other relevant coding guidelines.
• Validate and ensure the completeness, accuracy, and integrity of coded data.
• Identify and resolve coding discrepancies or discrepancies between clinical documentation and diagnosis coding.
• Stay up-to-date with the latest coding guidelines, rules, and regulations related to Risk Adjustment and HCC coding.
• Adhere to all compliance and HIPAA regulations to maintain data security and patient confidentiality.
• Collaborate with healthcare providers, physicians, and other team members to clarify documentation and resolve coding queries.
• Participate in coding education and training programs to enhance coding skills and knowledge.
• Prepare and submit reports related to coding activities, coding accuracy, and any coding-related issues or trends.
• Assist in internal and external coding audits to ensure the quality and compliance of coding practices.
• Identify opportunities for process improvement and efficiency in the coding process.
• Offer suggestions to enhance coding documentation and accuracy.

Requirements

Qualifications:

• Minimum CPC or CCS certification from AHIMA or AAPC is required. Higher-level certifications such as CRC (Certified Risk Adjustment Coder) is a significant advantage.
• Minimum two years of experience in Risk Adjustment and HCC coding in a healthcare setting.
• Strong knowledge of ICD-10-CM coding guidelines and CMS-HCC risk adjustment methodology.
• Familiarity with electronic health record (EHR) systems and coding software.
• Excellent attention to detail, analytical skills, and ability to work independently.
• Strong communication and interpersonal skills for collaboration with medical professionals and team members.
• Understanding of compliance and confidentiality regulations, including HIPAA.

Advantmed is a privately held company founded in 2005. The organization initially focused on record retrieval but has evolved into an innovative healthcare information management company that helps health plans and Managed Care Organizations optimize revenue and improve quality outcomes. Our mission is to improve the healthcare system by ensuring appropriate, quality care and eliminating unnecessary costs. We accomplish this by providing a cost-effective suite of capabilities tailored to the unique needs of our clients, including NCQA-certified HEDIS® measure software, risk analytics, medical record retrieval, medical record abstraction, risk adjustment coding, data validation, prospective assessments, and provider education.

Our strategy reflects our flexibility and commitment to meeting our clients' evolving needs. We work closely with our clients to understand their concerns, requirements, strategic objectives, and infrastructure so that we can support them accordingly. Our foundational principles are accuracy, efficiency, and transparency. Our solutions are designed to be user-friendly and flexible.

We see ourselves as an extension of our clients’ internal teams, which allows us to work to advance our solutions and provide support for their growing business needs. Understanding how our clients use our products and services fuels our product development road map, especially in terms of technology as we continually work to improve our client portal. In addition, we regularly monitor statutory and regulatory changes from CMS, HHS, NCQA, and others.

The Advantmed leadership team is composed of seasoned healthcare veterans, with extensive quality and risk adjustment expertise. The leadership team oversees a global staff of over 1,800 employees. Notably, we are HITRUST certified, and all data resides within the United States.