Medical Coding Specialist

Hours:

20 flexible hours per week (Part time). Mon- Fri Duration:

Possible contract to hire

Job Description: Hours/Schedule: 20 flexible hours per week (Part time). Training hours will start between 8:00am - 11:00am. 3 years of ICD-10 or HCC experience. License/Certification required: CCS or CPC. Occasionally comes onsite for teams meetings. Risk adjustment coding for all models. Coding a minimum of 25 charts per day. Hold an accuracy of 95%. Microsoft office skills. Reviews medical documentation to perform a variety of coding validations for multiple lines of business under Medicare/TRICARE to determine accuracy of billing and payment. Reassigns and sequences diagnostic and procedural codes using universally recognized coding system as appropriate. Compiles and analyzes statistics to determine focus areas for targeted medical review activities where there is the greatest potential for inappropriate Medicare/TRICARE payments.

Responsibilities: Determines methodology to identify cases for DRG, HIPPS, HCPCS, RUG, and APC validation. Conducts targeted coding, documentation reviews, and validation reviews coordinating rate adjustments and adjudication of corresponding claims. Utilizes Grouper, Rover, MDS QC tool or other appropriate software for code validation. Compiles/analyzes statistics to determine focus areas for targeted medical review activities where there is the greatest potential for inappropriate Medicare/TRICARE payments demonstrating records reviewed, outcomes, trends, and savings. Notes deficiencies and makes recommendations to management and others as appropriate/requested. May complete appropriate paperwork/documentation regarding claim/encounter information to correct deficiencies. Provides coding guidance to clinical review staff. Develops necessary training or reference materials for review staff. Consults with appeals, provider outreach and education and other supported areas of division as needed as a resource for medical records and coding issues.

Experience: 2 years: 1-year clinical experience and 1 year in either ICD-9, DRG, APC, HIPPS, HCPCS, or RUG coding and validation.

Skills: Working knowledge of word processing software. Knowledge/understanding of medical terminology and medical coding. Good judgment skills. Demonstrated customer service and organizational skills. Demonstrated proficiency in spelling, punctuation, and grammar skills. Analytical or critical thinking skills. Ability to handle confidential or sensitive information with discretion. Preferred Skills and Abilities: Knowledge/understanding of Medicare billing process. Working knowledge of spreadsheet and database software. Preferred Software and Other Tools: Working knowledge of Microsoft Excel, Access, or other spreadsheet/database software.

Education: Associate degree - Health Information Management, OR Graduate of an Accredited School of Nursing.

About US Tech Solutions: US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit

www.ustechsolutions.com .

US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Recruiter's detail: Name: Shailesh Chaturvedi Email: shailesh.c@ustechsolutionsinc.com Internal ID: 26-03733