Medical Coding Analyst - Ultimate Staffing Services

Position Title: Medical Coding Analyst

Location: Oakland, CA - Hybrid after the initial 90-day period

Schedule: M - F 8:00 AM - 5:00 PM

Duration: Direct Hire

Salary: $30 - $35/ hour

Medical Coding Analyst

Responsible for the creation and auditing of all monthly and ad hoc outbound encounter/HCC reporting as well as analysis of inbound reports. The role performs data analysis and works with internal and contracted providers to meet compliance thresholds.

General Duties and Responsibilities:

• Ensure that all encounters and HCCs are corrected according to industry standards and guidelines set by CMS and DHCS.
• Interprets, analyzes, and assigns diagnostic/HCC codes to ensure compliance with governmental reimbursement policies, regulations and applicable guidelines.
• Researches, analyzes, and responds to inquiries regarding compliance, coding, and financial impact of coded diagnoses.
• Conduct Root Cause analysis for encounter/HCC errors and initiate process improvement or communications to resolve future occurrence.
• Ability to reviews and analyzes medical documentation and diagnosis listed accurately reflects the care and treatment.
• Establish and maintain strong relationships with Health Plans, Encounter Clearing Houses, external auditors/vendors, and internal stakeholders to fix, prevent, and to obtain extra support in resolving encounter and HCC coding errors.
• Assigns a variety of diagnostic codes in ICD 10 CM with careful attention to the PACE HCC reimbursement model.
• Create daily and weekly reports highlighting the correlation of patterns, trends, etc.

Qualifications:

• Bachelor's Degree in Health Information Administration and two years of medical coding experience; or four years as a medical coder.
• One of the following Coding Certifications
  • Certified Professional Coder
  • Certified Coding Specialist
  • Other AHIMA or CPC certification specific to HCC/Risk Adjustment Coding

All qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the California Fair Chance Act, City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, and Los Angeles County Fair Chance Ordinance. For unincorporated Los Angeles county, to the extent our customers require a background check for certain positions, the Company faces a significant risk to its business operations and business reputation unless a review of criminal history is conducted for those specific job positions.