4 medical coding specialist jobs found in San Francisco, CA

Job Description The Position : Responsible for the accurate coding, coding review, and submission of eligible participant diagnoses to CMS. DUTIES AND RESPONSIBILITIES: * Oversee all aspects of HCC and frailty coding operations for Center for Elders' Independence. * Interprets, analyzes, and assigns diagnostic codes to ensure compliance with governmental reimbursement policies, regulations and applicable guidelines. * Reviews provider coded encounters for accuracy of diagnoses. * Abstracts all CMS participant eligible diagnoses into a CMS submittal format. * Reviews and analyzes medical documentation to ensure that the final diagnosis listed accurately reflects the care and treatment submitted for reimbursement. * Collaborates and coordinates with external auditors; provides feedback on audit reports as appropriate. * Identifies inconsistencies, discrepancies and/or trends within the medical record and discusses with the appropriate medical providers. Recommends appropriate...

Job Description Who We Are: Apixio is advancing healthcare with data-driven intelligence and analytics. Our Artificial Intelligence platform gives organizations across the healthcare spectrum the power to mine clinical information at scale, creating novel insights that will change the way healthcare is measured, care is delivered, and discoveries are made. About the role: The Supervisor is responsible for driving consistency and quality across Apixio coding teams, related to Risk Adjustment HCC coding and customer guidelines. The Supervisor will work closely with other Apixio coding managers to establish and implement workflows and training programs that will achieve a high level of coder performance, measured by coder accuracy and productivity. The Supervisor will coach, counsel, and mentor Apixio production Coders and QA specialists in an effort to improve teamwork, morale, and overall coding quality and results. The Supervisor will demonstrate Service Excellence at all times....

Immediate Opening for San Ramon, CA and Bay Area territory, this position will require visiting Providers and will be hybrid. Please apply today for consideration! The Risk Adjustment Coder II provides support and coding expertise to all programs that support risk adjustment and data validation efforts for our Medicare, Commercial and PPO lines of business, along with other ad hoc and long-term projects assigned by the Manager, Government Programs. These projects impact revenue and prepare us for health plan, CMS and HHS audits. In addition, the Risk Adjustment Coder will provide analytics, education, in-person trainings in provider offices, and serve as the subject matter expert for all HCC coding initiatives, policies and procedures that adhere to our organizations coding guidelines and compliance standards. The position will interact with physician leadership, the provider network, and internal departments within the organization (e.g. Regional Services, Clinical Services,...

Job Description Job Title: Certified Professional Coder Job Category: Administrative Reports To: Coding Manager Position Type: Full Time Position Supervisory Responsibility: This position has no supervisory responsibilities Exempt/Non-Exempt: Non-Exempt Job Description Role and Responsibilities The Certified Coding Specialist is responsible for assigned work queue's for physician services via medical records (encounter) for office visits, outpatient surgery, office procedures and hospital visits utilizing ICD-10-CM and CPT-4 codes. This requires thorough review of the medical record to validate assigned codes for optimal reimbursement. Research coding and regulatory guidelines that impact coding and billing for services to obtain relevant and timely information for internal utilization utilizing ICD-10-CM and HCPCS/CPT-4 codes. Ensures appropriate charge capture. Essential Functions: Reasonable accommodations may be made to enable individuals with disabilities to perform the...