Coding Specialist (Certified)

US-LA-Peoples Health- Metairie
Job ID
3490
Category
Professional - All

Overview

To increase revenue, accuracy of payment  and quality of care by identifying and submitting unreported validated medical diagnosis and delegating diagnosis that were submitted inappropriately.

 

Will draw on extensive coding knowledge to review, code and submit / delete diagnoses in order to continuously ensure the resources and benefits required to care for our members.

Responsibilities

Principal Responsibilities

  • 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
  • Evaluate and communicate documentation and coding deficiencies in provider records
  • Conduct chart reviews to validate data accepted by CMS
  • Maintain professional relationships with physicians and/or staff
  • Maintain work calendars and comply with all internal processes
  • Understand and keep up-to-date with Risk Adjustment Guidelines
  • Set priorities for own work assignments and uses initiative in completion of tasks
  • Participate in auditing projects as assigned
  • Assist in training new members of the coding team
  • Assist in special projects as directed

Core Competencies

  • Sound business ethics
  • Professionalism
  • Ability to work independently
  • Ability to meet deadlines
  • Excellent organizational skills with great attention to detail
  • Strong communication and interpersonal skills

Qualifications

  • Certified Professional Coder (CPC) certification required (through AHIMA or AAPC) 
  • Minimum of  three years successful employment in coding required
  • Proficiency in utilizing MS Word, Excel and Outlook
  • Must be able to work independently and meet deadlines
  • CCS-P certification highly preferred.

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