Amerihealth Caritas Health Plan Philadelphia , PA 19107
The Medical Coding Specialist, Senior is responsible to abstract and code diagnosis information and/or medical conditions documented in physician office medical records using CMS, ICD and/or Department defined criteria and guidelines.
The Senior Specialist will receive and review medical records electronically and document ICD-10 codes or discern and apply appropriate error codes affecting completion of abstraction using computer software. The Senior level position will also be assigned abstraction and coding of medical records deemed too difficult for the Coding Specialist staff, due to medical record deficiencies, and will define and document corrective action suggestions for presentation to the provider.
The Medical Coding Specialist Sr, is responsible for meeting average daily production goals on all first level reviews while maintaining a minimum 95% accuracy rate on a consistent basis.
Required High School Diploma required (Associates Degree preferred)
Required to be certified by AACP or AHIMA.
Required successful completion of at least one AHIMA or AAPC certification program with achievement correlating professional credential (RHIT, CCS, CPC, etc.) active and in good standing.
Required: Certified Risk Adjustment Coder (CRC) credential wth experience in Medicaid /CPDS Coding
Required HCC coding experience.
Required 3-5 years hands on production abstracting or auditing medical records for diagnosis/ medical condition coding.
Required ICD-10 proficiency validation.
Required proficiency with MicroSoft applications.