Benchmarking, Content Management Systems (CMS), Current Procedural Terminology (CPT), HIPAA (Health Insurance Portability and Accountability Act), Healthcare Common Procedure Coding System (HCPCS), ICD-10, Internet/Online Service, Leadership, Maintain Compliance, Manufacturing Data Management, Medical Coding, Outpatient Care, Patient Confidentiality, Risk, Time Management, Training/Teaching
City of Industry, CA(remote)
- Assign accurate CPT , ICD-10-CM, and HCPCS Level II codes for outpatient E/M services based on Medical Decision Making (MDM) and current guidelines.
- Apply HCC (Hierarchical Condition Category) coding principles to support risk adjustment and complete clinical documentation.
- Review provider documentation for completeness, specificity, and medical necessity; query providers when needed.
- Ensure compliance with CMS, AMA, ICD-10-CM guidelines, payer requirements, and internal coding policies.
- Meet established coding productivity and quality benchmarks.
- Assist with coding audits, provide education feedback, review denials, and support other coding projects as assigned.
- Participate in team meetings, training sessions, and after-hours meetings scheduled in Pacific Time.
- Maintain patient privacy and confidentiality in accordance with HIPAA and organizational standards.
- Stay updated on coding guideline changes, E/M and HCC/risk-adjustment updates, and payer requirements.
- Collaborate professionally with coding leadership, clinical staff, and revenue cycle teams.
- Perform other related coding duties as required.P
ProEd Consulting and Staffing