Healthcare Coder

Overview Perform professional fee coding and auditing to ensure compliance with official coding guidelines and accuracy in diagnosis and procedure codes. Validate patient demographics, insurance details, and carrier assignments to ensure proper claim submission and provider billing group classification. Compose physician-friendly feedback and inquiries following prescribed workflows to support coding and auditing processes. Utilize expertise in renal specialty coding and auditing to train others and maintain high accuracy rates. Prepare daily coding logs, track production independently, and achieve a coding production rate of 95% or above. Conduct claim editing activities, troubleshoot problem accounts, and perform root cause analysis for escalation as needed. Maintain proficiency in ICD-10 and CPT coding with an accuracy rate of 95% or above. Collaborate with revenue cycle management leadership to address escalated issues and improve processes. Key Responsibilities & Duties Analyze and review medical records to ensure accurate code assignment for professional fee charts. Validate clinical code assignments and prepare claims for submission with correct provider billing group classifications. Compose compliant, physician-friendly feedback for provider inquiries and code validation audits. Track and maintain coding production rates and accuracy metrics independently. Perform claim editing, troubleshoot issues, and conduct root cause analysis for problem accounts. Utilize expertise in renal specialty coding to audit, code, and train others effectively. Ensure compliance with coding guidelines and maintain high accuracy in ICD-10 and CPT coding. Collaborate with leadership to address escalated issues and enhance coding processes. Job Requirements High School Diploma or GED required; additional certifications preferred. Minimum of 3 years of coding experience; 5 years preferred. Approved credential from AHIMA or AAPC, such as Certified Professional Coder. Expertise in risk adjustment coding and HCC certified coding credential preferred. Proficiency in Microsoft Office applications and internet connectivity meeting specified requirements. Ability to work autonomously and maintain high accuracy and production rates. Experience in renal care, value-based care, or startup environments is advantageous. Strong communication and analytical skills with a focus on compliance and accuracy. #J-18808-Ljbffr Greenkey Resources LLC