Medical Coder II

Description

Perform coding validation accuracy reviews of automated and complex Medicare medical record and claims review in accordance with all Federal regulations /guidelines CMS coding policies and coding clinics. Document findings for each claim and a clear and concise manner. Compile a report explaining the coding reviews including identified patterns inappropriate coding as well as recommendations.

Responsibilities:  

• Perform coding validation accuracy reviews of automated and complex Medicare Part A and Part B medical record and claims review in accordance with all Federal regulations/guidelines, CMS coding policies and coding clinics
• Document findings for each claim and a clear and concise manner. Compile a report explaining the coding reviews, including identified patterns, inappropriate coding, as well as recommendations
• Perform Inpatient DRG validation and Ambulatory Payment Classification (APC) reviews to include the review documents used
• Perform coding validation of the medical record reviews in response to RAC disputes/disagrees with the RVC review decisions
• Maintain a Quality Assurance monthly score of 95% or greater

Qualifications

Requirements:

• Certified Coder from an accredited association, such as AAPC or AHIMA
• Certified Coders may also be Registered Health Information Administrators (RHIA) and Registered Information Technicians (RHIT) credentialed by AHIMA
• Not excluded or sanctioned from working with the Centers for Medicare and Medicaid Services (CMS)
• A minimum of five (5) years direct coding or billing experience in the specific coding field that they will perform
• Ability to work well in a remote team environment, to collaborate with others, and interface with team members internal and external to the organization
• Proficient in explaining review decision through written decisions using related regulations and references
• All aspects of Inpatient and Outpatient coding (ICD-10, CPT, HCPCS) experience

​​​EEO Employer:

RELI Group is an Equal Employment Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information, or any other basis protected by law, ordinance, or regulation.

HUBZone:

We encourage all candidates who live in a HUBZone to apply. You can check to see if your address is located in a HUBZone by accessing the SBA HUBZone Map.

The annual salary range for this position is $40,000 to $65,000. Actual compensation will depend on a range of factors, including but not limited to the individual’s skills, experience, qualifications, certifications, location, other business and organizational needs, and applicable employment laws. The estimate displayed represents the typical salary range for this position and is just one component of the total compensation package for employees. RELI Group provides a variety of additional benefits to its employees. For additional details on the benefits that RELI Group offers click here.

Salary : $40,000 - $65,000