Medical Coder

Job title: Associate Med Coder (Business title: Medical Coder MCC).

Job Code: MCO410

Division/Department: MCC

Reports to: Team leader

Prior Experience: Minimum work experience of 1 year is required.

Full-time: Yes

Work from office: Yes

Travelling Onsite / Offsite: No

Essential Duties and Responsibilities:

• The coder will evaluate medical records to verify the plan of care for chronic medical conditions.
• The coder will perform accurate and timely coding review and validation of Hierarchical Condition Categories (HCCs) and Diagnoses through medical records. The coder will document ICD-10-CM codes to verify that coding meets both established coding standards as well as CMS Risk Adjustment Guidelines.
• The coder will assist the project teams by completing review of all charts in line with Medicare & Medicaid Risk Adjustment criteria.
• Apply understanding of anatomy and physiology to interpret clinical documentation and identify applicable medical codes.
• Verify and ensure the accuracy, completeness, specificity and appropriateness of diagnosis codes based on services rendered.
• Evaluate medical record documentation to ensure coding accurately reflects and supports relevant coding based on the ICD-10 code submitted to CMS for reimbursement and interpretation of medical documentation to ensure capture of all relevant coding based on CMS Hierarchical Condition Categories (HCC)conditions that are applicable to Medicare Risk Adjustment reimbursement initiatives
• Demonstrate analytical and problem-solving ability regarding barriers to receiving and validating accurate HCC information
• Meet the production targets
• Meet the Quality parameters as defined by the Client SLA
• Other duties as assigned by supervisors.

Education and/or Work experience:

• Medical coding fresher and up to 5 years of work experience. HCC coding work experience is highly preferred. Candidates with experience in other medical coding work experience can be considered provided they demonstrate technical competence in ICD-10 CM and risk adjustment guidelines and standards.
• AAPC/AHIMA Certification is mandatory (CRC is most preferred followed by CPC, CIC or COC) or AHIMA-CCS certified.
• Good knowledge in Anatomy, Physiology & Medical terminology.
• Graduates in Medical, Paramedical or Life Science disciplines are preferred. Graduates from other disciplines may be considered subject to their ability to demonstrate technical competence in ICD-10 CM and risk adjustment guidelines and standards.