To increase revenue and quality of care by identifying and submitting unreported validated medical diagnosis. Will draw on extensive coding knowledge to submit unaccepted diagnoses in order to continuously ensure the resources and benefits required to care for our members.
Travel within the service area to perform medical record reviews
Conduct research in order to define suspects
Perform chart reviews based on suspects to recover diagnoses not coded
Conduct chart reviews to validate data accepted by CMS
Enter data recovered for reporting purposes
Maintain professional relationships with physicians and/or staff
Understand and keep up-to-date with Risk Adjustment Guidelines
Set priorities for own work assignments and uses initiative in completion of tasks
Assist in special projects as directed
Certified Professional Coder (CPC) certification required. A High School Diploma and three years of successful employment in coding/billing required. Must be proficient in utilizing MS Word, Excel and Outlook. Excellent oral and written communication skills needed. Must be able to work independently and meet deadlines. Excellent organizational skills and attention to detail a must! CCS-P certification highly preferred.
The Peoples Health Perspective on Employees
In the face of continued growth, our local roots help us maintain a warm and friendly...