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Medical Claims Processor

Company: Kelly
Location: Bridgewater
Posted on: May 12, 2022

Job Description:

We're seeking for a Medical Claims Processor for a premier personalized local healthcare provider located in Bridgewater MA.Job Title: Medical Claims Specialist (Risk-Coder)
Terms of Employment: Permanent Direct-HireSummary:The primary function of this position is to ensure accurate documentation, coding and billing of services provided.Responsibilities:

  • Provide training, problem solving and performance monitoring for associates.
  • Work with Senior Risk Coder and Team members to perform Retrospective audits for identified open gaps.
  • Participates in process improvement activities, staff development and monitors compliance with organizational and departmental policies.Requirements:
    • Must be a member of AAPC or AHIMA
    • Must be credentialed as CCS-P, CPC, or COC.
    • Must be credential as CRC (Certified Risk Coder)
    • Advanced level knowledge of medical terminology.
    • Must have working knowledge of ICD-10-CM coding conventions and be proficient in Volumes 1- 2, CPT and HCPCS coding.
    • Must have a working knowledge of HCC and risk adjust coding guidelines.
    • Extensive knowledge of official coding conventions and rules established by the American Medical Association (AMA), and the Center for Medicare and Medicaid Services (CMS) for assignment of diagnostic and procedural codes.
    • Knowledge of and experience with an Electronic Health Record is preferred.
    • Must have effective communication skills to insure professional and effective dialogue with providers.
    • Requires skill in the use of a wide variety of office equipment including: personal/laptop computer/tablet, calculator, FAX, scanners, copy machine, and other office equipment as required.
    • Knowledge of Excel is preferred.
    • Must be able to follow instructions and work independently.
    • Maintain proficiency and accreditation status by attending educational sessions as appropriate and available.
    • Requires some travel to meet with and educate providers in hospital or office locations.Education:
      • Completion of high school, or equivalent.Experience:
        • Two-four years of coding experience in outpatient professional settingCertification/Licensure:
          • Certification is required as CPC, CCS-P, or COC and CRCSoftware/Hardware:
            • Experience and familiarity with electronic health record systems, and Microsoft Office, experience with excel preferred.

Keywords: Kelly, Brockton , Medical Claims Processor, Healthcare , Bridgewater, Massachusetts

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