Medical Risk Coder at FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA INC

Fort Myers, Florida, United States -

Full Time

Start Date

Immediate

Expiry Date

25 Jan, 26

Salary

0.0

Posted On

27 Oct, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Medical Coding, CPT Coding, HCPCS Coding, ICD-10 Coding, Risk Coding, Documentation Auditing, Compliance Regulations, Medicare Guidelines, Medicaid Guidelines, Insurance Procedures, FQHC Billing Procedures, HIPAA Guidelines, Coding Consultation, Data Validation, Patient Encounters, Reimbursement Processes

Industry

Hospitals and Health Care

Description

Description POSITION DESCRIPTION: Responsible for the accurate and efficient coding of FHC medical records in compliance with all legal regulations and accepted standards. DETAILED DUTIES AND RESPONSIBILITIES: Review accounts for coding and abstracting of patient encounters, including diagnostic and procedural information, significant reportable elements, and complications. Audits clinical documentation and coded data to validate documentation supports diagnoses, procedures and all services rendered for reimbursement and reporting purposes. Identifies diagnostic and procedural information and reviews physician pending charges for appropriate complexity using CPT coding guidelines. Assigns codes for reimbursements and compliance with regulatory requirements utilizing guidelines and following up to date coding conventions. Works closely with the Coding Administrator to provide feedback to providers to improve documentation practices. Confirm patient demographic, insurance and referring physician information is accurately entered in Intergy. Enter all codes, CPT, HCPCS and ICD-10 coding and modifiers in Intergy timely and accurately. Follow established checks and balances systems to ensure complete and accurate code capture. Review Medicare Local Coverage Determinations (LCDs) and Medicare bulletin updates and Medicare NCCI. Serves as coding consultant to providers. Keeps abreast of compliance regulations, standards, and directives regarding governmental/regulatory agencies and third-party payers. Keeps abreast of standard coding guidelines (including Medicare, Medicaid, Managed Care, HEDIS, and FQHC guidelines). Provides updates and status reports to management weekly. Other duties as assigned. Requirements KNOWLEDGE: Demonstrated knowledge of Medicaid, Medicare, and Commercial Insurance rules and procedures in a managed care plan environment Medical terminology, CPT, HCPCS and ICD-10 coding and modifier usage required Understanding of FQHC billing procedures and Sliding Fee Schedules a plus Understand and adhere to all HIPAA guidelines SKILLS AND ABILITIES: 2 years’ Medical Coding experience required Certified Risk Coder (CRC) Certification required

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Responsibilities

The Medical Risk Coder is responsible for the accurate coding of medical records and ensuring compliance with legal regulations. This includes reviewing accounts, auditing clinical documentation, and assigning codes for reimbursement.