HealthCare Partners is the largest physician-owned and led IPA in the Northeast, serving New York's five boroughs and Long Island with over 6,000 primary care physicians and specialists, providing care to 125,000 members enrolled in Commercial, Medicare, and Medicaid products.
The Coding Analyst provides Risk Adjustment/HCC coding and auditing services, analyzing and translating medical and clinical diagnoses, procedures, injuries, or illnesses into designated alphanumerical codes. The role includes summarizing audit results and providing feedback and education to field teams and providers about documentation requirements.
Responsibilities include reviewing medical records to assign ICD-10 CM and CPT codes accurately, verifying accuracy and completeness of medical records, applying medical coding references and guidelines, reviewing coding patterns, identifying and communicating coding issues and opportunities for improvement, interpreting coding rules and policies, ensuring valid encounters, responding to medical coding quality audits, maintaining up-to-date knowledge of coding rules, and meeting established quality and productivity standards.
- Experience in medical coding/auditing with diagnosis coding
- Knowledge of medical terminology including anatomy and physiology
- Strong background in ICD-10 coding
- Knowledge of CPT and CPT II (HCSPCS) codes
- HCC and risk adjustment model experience strongly preferred
- Intermediate proficiency with Microsoft Excel (Pivot tables, charts)
- Strong verbal and written communication and organizational skills
- Active membership ID with AAPC or AHIMA required
- Proficient with Excel and MS Office
- Ability to perform in high productivity, fast-paced environments
- Knowledge of ICD-10 CM Guidelines and CMS Risk Adjustment Guidelines
Education:
- High school diploma or GED required
- Associate or Bachelor degree in healthcare discipline preferred
- Medical coding credentials (CCS, CCS-P, or CPC) from AAPC or AHIMA, maintained annually, required
- CRC or CPMA credentials preferred
- Proficient in navigating electronic medical records and healthcare billing systems
Experience:
- 3+ years inpatient facility coding experience with quality and productivity standards
- 3+ years outpatient facility coding auditing preferred
- 1+ year inpatient and/or outpatient facility coding experience
- 1+ year auditing experience preferred
- Knowledge of Risk Adjustment coding
- 1 year healthcare provider education experience
Location
New York, US
Employment Type
Full-time
Experience Level
Intermediate Level
Salary Range
$65,000 - $75,000
Remote work allowed
No
Posted
4 weeks ago