CPC, CRC, CCS, or CCS-P credentials required; CPMA credential preferred., 3+ years of experience in a Certified Coder role and HCC coding., Proficiency in medical terminology, anatomy, and physiology., Experience with Microsoft Office and Electronic Medical Records..
Key responsabilities:
Conduct monthly audits of APP/MDs and Certified Coding teams.
Ensure coding accuracy and compliance with documentation guidelines.
Provide education and training to clinicians and coding teams.
Analyze data to identify trends and develop new policies.
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Monogram Health is a leading value-based specialty provider of in-home evidence-based care and benefit management services for patients living with polychronic conditions, including chronic kidney and end-stage renal disease.
The Monogram Senior Coding Auditor will be responsible for auditing our APP/MDs and Certified Coding teams monthly. Audit will include confirming all diagnosis codes and procedure codes have supporting documentation and are used correctly within the encounter. Senior Coding Auditor will be responsible for delivering results in a timely manner to all APP/MDs and Certified Coding teams monthly. Performs medical chart audits on a retrospective basis to identify, monitor and document claims and encounter coding information as it relates to complete documentation. Performs medical chart quality audits to ensure clinicians have accurate clinical documentation to support ICD-10 codes and are adhering to CMS Risk Adjustment guidelines. Educates clinicians and coders on specific coding issues found in their charts and keeps them abreast of coding and documentation guidelines.
Roles And Responsibilities
Maintains 95% coding accuracy rate
Maintains production goals
Experience working remotely with proven ability to prioritize tasks, meet goals and deadlines
Performs accurate and timely audits (CPT, ICD-10, HCPCS, modifiers).
Demonstrate advanced knowledge of medical terminology, anatomy, and physiology
Provides timely correspondence with providers regarding clinical documentation opportunities and queries.
Identifies trends through data analysis or chart review, reviewing existing policy for accuracy and developing new policies and recommends solutions to meet objectives.
Keeps abreast of mandated regulatory, documentation and coding guidelines to documentation, including demonstrated proficiency with all areas of CPT, ICD-10 and HCPCS coding. E/M code assignment, auditing, and education.
Performs quality audits, education, and training for coding team.
Works closely with leadership to create coding tools for coding team and providers.
Provides training and onboarding for new hires.
Performs other duties as required or assigned
Position Requirements
This position is a remote position.
CPC, CRC, CCS, or CCS-P credentials, required.
CPMA credential, preferred not required.
3+ years’ experience in Certified Coder role
3+ years’ experience in HCC coding
Experience billing is a plus.
Experience coding telehealth coding is a plus
Experience in Nephrology coding is a plus
Experience with medical billing is a plus.
Experience coaching and training peers is a plus.
Experience working with Athena is a plus.
Must have proficiency using a PC in a Windows environment, including Microsoft Word, Excel, Power Point and Electronic Medical Record.
Experience communicating & working closely with Physicians.
Experience in Medicare programs and regulations including fraud and abuse and Risk Adjustment
Familiar with STARs performance measures and metrics.
Benefits
Opportunity to work in a dynamic, fast-paced, and innovative value-based provider organization that is transforming the delivery of kidney care.
Competitive salary and opportunity to participate in the company’s bonus program
Comprehensive medical, dental, vision and life insurance
Flexible paid leave and vacation policy
401(k) plan with matching contributions
About Monogram Health
Monogram Health is a next-generation, value-based chronic condition risk provider serving patients living with chronic kidney and end-stage renal disease and their related metabolic disorders. Monogram seeks to fill systemic gaps and transform the way nephrology, primary care and chronic condition treatment are delivered. Monogram’s innovative, in-home approach utilizes a national nephrology practice powered by a suite of technology-enabled clinical services, including case and disease management, utilization management and review, and medication therapy management services that improve health outcomes while lowering medical costs across the healthcare continuum. By focusing on increasing access to evidence-based care pathways and addressing social determinants of health, Monogram has emerged as an industry leader in championing greater health equity and improving health outcomes for individuals with chronic kidney and end-stage renal disease.
At Monogram Health we believe in fostering an inclusive environment in which employees feel encouraged to share their unique perspectives, leverage their strengths, and act authentically. We know that diverse teams are strong teams, and welcome those from all backgrounds and varying experiences.
Required profile
Experience
Spoken language(s):
English
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