Medical Claims Processor
Posted on: May 12, 2022
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
- 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
- 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
- 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
- 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
- Knowledge of Excel is preferred.
- Must be able to follow instructions and work
- 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
- Certification is required as CPC, CCS-P, or COC and
- Experience and familiarity with electronic health record
systems, and Microsoft Office, experience with excel
Keywords: Kelly, Brockton , Medical Claims Processor, Healthcare , Bridgewater, Massachusetts
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