Certified Coder (Risk Adjustment/Outpatient Required)

JOB DESCRIPTION
Job Summary
Provides support to the business by making sure proper ICD-10 and CPT codes are reported accurately to maintain compliance and to minimize risk and denials.
KNOWLEDGE/SKILLS/ABILITIES
<ul>
<li>Performs on-going chart reviews and abstracts diagnosis codes</li>
<li>Develop an understanding of current billing practices in provider offices to ensure that diagnosis and CPT codes are submitted accordingly</li>
<li>Documents results/findings from chart reviews and provides feedback to management, providers, and office staff</li>
<li>Provides training and education to network of providers on how to improve their risk adjustment knowledge as well as provide coding updates related to Risk Adjustment</li>
<li>Builds positive relationships between providers and Molina by providing coding assistance when necessary</li>
<li>Responsible for administrative duties such as planning, scheduling of chart reviews, obtaining of medical records, and provider training and education</li>
<li>Assists in coordinating management activities with other departments in Molina including Finance, Revenue analytics, Claims and Encounters, and Medical Directors</li>
<li>Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies</li>
<li>Contributes to team effort by accomplishing related results as needed</li>
<li>Other duties as assigned</li>
<li>  2 years previous coding experience</li>
<li>Proficient in Microsoft Office Suite</li>
<li>Ability to effectively interface with staff, clinicians, and management</li>
<li>Excellent verbal and written communication skills</li>
<li>Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA) </li>
<li>Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers, and customers</li>
<li>Maintain knowledge in the latest coding guidelines (official through CMS) as well as AHA Coding Clinic guidance</li>
</ul>
 
JOB QUALIFICATIONS
Required Education
Associates degree or equivalent combination of education and experience 
Required License, Certification, Association
<ul>
<li>Certified  Professional Coder (CPC)</li>
<li>Certified Coding Specialist (CCS)</li>
</ul>
Preferred Education
Bachelor's Degree in related field
Preferred Experience
<ul>
<li>Familiar with HCC (Hierarchical Condition Categories) Risk Adjustment Model</li>
<li>Background in supporting risk adjustment management activities and clinical informatics</li>
<li>Experience with Risk Adjustment Data Validation</li>
</ul>
Preferred License, Certification, Association
<ul>
<li>Certified Risk Adjustment Coder – (CRC)</li>
<li>Certified Professional Payer – Payer (CPC-P)</li>
<li>Certified Coding Specialist – Physician based (CCS-P)</li>
</ul>
 
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Certified Coder (Risk Adjustment/Outpatient Required) - REMOTE

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