Back to Jobs

Remote Risk Adjustment Data Validation and Medical Record Review Certified Coder in USA

Remote, USA Full-time Posted 2025-05-22

Remote Risk Adjustment Data Validation and Medical Record Review Certified Coder - Cherokee Nation Businesses - USA - work from home job

Company: Cherokee Nation Businesses

Job description: Job Description:

A RADV Certified coder conducts tasks including medical coding abstraction and medical record review. This person conducts evaluates medical records, conducts medical coding abstraction, provides secondary review and quality assurance of medical coding intake and abstraction. This person provides professional expertise in accurately managing industry standard volumes of coding abstraction, medical record review, and risk adjustment data validation.

Compensation & Benefits:

Estimated Starting Salary Range for Remote RADV Certified MedicalCoder: Pay commensurate with experience.

Full time benefits include Medical, Dental, Vision, 401K and other possible benefits as provided. Benefits are subject to change with or without notice.

Certified medical Coder Responsibilities Include:
• Understand and represent CMS Center for Program Integrity's mission, vision, and values to all internal and external customers
• Audits chart notes and external documentation based on industry standard coding guidelines
• Review charts, code chronic disease that meets HCC and Risk Adjustment criteria
• Utilizes technical coding principals and APC reimbursement expertise to assign appropriate diagnoses and/or procedures.
• Ensures optimal reimbursement of all cases in compliance with CMS policies and procedures and Official Coding Guidelines
• Keeps abreast of coding guidelines and reimbursement reporting requirements
• Ensures production and quality expectations are met
• Communicates professionally and effectively with physicians and staff
• Performs accurate chart reviews and assigns appropriate ICD-9 and ICD-10 CM codes based on documentation in chart
• Identifies and reports issues or errors, such as incomplete or missing records and documentation, ambiguous or nonspecific documentation, or codes that do not conform to approved coding guidelines
• Maintains consist daily production of greater than 30-50 reviews per day.
• Maintains 95% or greater accuracy rate
• Demonstrates the ability to appropriately use coding principles to code to the highest specificity and complies with CMS regulations and company goals and policies
• Reports operational concerns to manager for Quality Improvement of daily processes
• Demonstrates knowledge of various document types - e.g. paper records and electronic records
• Performs other job-related duties as assigned

Senior Coder Experience, Education, Skills, Abilities requested:
• Must have Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT), or Certified Coding Specialist (CCS).
• HCC Certified Coder preferred
• Associate degree preferred
• Minimum of two years' experience in medical record intake, abstraction, and review leveraging ICD-9 and/or 10 standards for inpatient and outpatient settings
• Understands and adheres to HIPPA requirements
• Maintains professional certification
• Knowledge of CMS CDAT-M systems is preferred
• Excellent organization and time management skills along with excellent oral and written communication skills
• Ability to learn quickly, build and maintain long term relationships and work with minimal supervision
• Ability to work well with others with diverse backgrounds and at various organizational levels
• Ability to work well within a team
• Consistently reliable and available given remote nature of work
• Has sufficient internet services to meet all requirements
• Must have no conflict of interest (COI) as defined in 1154(b)(1) of the Social Security Act (SSA)
• Ability to obtain and maintain U.S. Government Security Clearance
• Demonstrated commitment to continuous learning and keeping up-to-date with the latest programming languages, frameworks, tools, and industry trends.
• Ability to lead and mentor other coders, providing guidance, code reviews, and promoting coding best practices within a team or organization.
• Strong interpersonal and communication skills to effectively collaborate with cross-functional teams, understand requirements, and articulate technical concepts to both technical and non-technical stakeholders.
• Ability to adapt to changing technologies, methodologies, and project requirements, while maintaining a focus on delivering high-quality software solutions.
• Strong attention to detail to ensure code correctness, maintainability, and adherence to coding standards and software specifications.
• Effective time management skills to prioritize tasks, manage workloads, and meet project deadlines in a fast-paced development environment.
• Must pass pre-employment qualifications of Cherokee Federal

Company Information:

Cherokee Nation Strategic Programs (CNSP) provides support, services, and solutions to federal and commercial customers. The company takes a personalized approach to solving our clients' toughest challenges, helping you make the most of your skills. CNSP is part of Cherokee Federal - a team of tribally owned federal contracting companies. For more information, visit cherokee-federal.com.

#CherokeeFederal #LI #LI-Remote

List similar searchable job titles 5 times:
• Risk Adjustment Coder
• Medical Record Review Coder
• Certified Coding Specialist for Risk Adjustment
• Data Validation Coder
• Remote Coding Auditor

List Keywords 5 times:
• RADV
• ICD-9 or ICD-10
• Medical record review
• Coding
• Data validation

Please Note: This position is pending a contract award.

If you are interested in a future with Cherokee Federal, APPLY TODAY! Although this is not an approved position, we are accepting applications for this future and anticipated need.

Legal Disclaimer: Cherokee Federal is an equal opportunity employer. Please visit cherokee-federal.com/careers for information regarding our Affirmative Action and Equal Opportunity Employer Statement, and Accommodation request.

Expected salary:

Location: USA

Job date: Sun, 17 Sep 2023 04:19:16 GMT

Apply for the job now!

Apply Job!

 

Similar Jobs

Customer Service Representative Team Lead - National Remote

Remote, USA Full-time

Operations Supervisor - Night Shift

Remote, USA Full-time

VP of AI Research and Development, Trilogy (Remote) - $200,000/year USD

Remote, USA Full-time

Part Time Sales Representative – Work from Home Remotely

Remote, USA Full-time

Customer Service Representative - Hybrid

Remote, USA Full-time

Inbound Patient Account Services Coordinator (Remote)

Remote, USA Full-time

Customer Service Representative – Sales (Hybrid)

Remote, USA Full-time

Customer Quality Specialist (On-Site)

Remote, USA Full-time

Amazon Ecommerce Manager

Remote, USA Full-time

Life Underwriting Consultant I

Remote, USA Full-time

Immediately Require Elementary School Tutor in Dayton, OH

Remote, USA Full-time

Call Center Specialist - Full Time Days - ATL Command Center

Remote, USA Full-time

Managed Account Coordinator - 1st Shift

Remote, USA Full-time

Commercial Insurance Sales Producer (Remote - U.S. Based)

Remote, USA Full-time

Amazon Work at Home Customer Support positions

Remote, USA Full-time

In Home Assembly and Installation Technician II supporting Amazon at Goodman Solutions Chantilly, Fairfax County, VA

Remote, USA Full-time

Customer Service Representative - Phone and Chat - Dallas, TX

Remote, USA Full-time

Senior Software Engineer (Full-Stack), Taxes & Bookkeeping San Francisco, Seattle, Portland, Ne[...]

Remote, USA Full-time

Remote WFH Data Entry-Typing-Entry Level

Remote, USA Full-time

Pharmacy Customer Service Associate

Remote, USA Full-time