Senior Medical Coder

Senior Medical Coder - Medicare Advantage - Risk Adjustment

Job Location: Remote, USA

Shift: Monday-Friday normal business hours

Employment Type: Temporary

FT/PT: Full-Time

Estimated Duration (In months): 4

Min Hourly Rate($): 18.50

Max Hourly Rate($): 18.50

Must Have Skills/Attributes: ICD-10, Medical Terminology, Medicare

Position Summary

Rose International is seeking a self-starting Accounting Manager — Revenue Recognition and Technical Accounting to join a Corporate Accounting team.

The position requires substantial accounting expertise, business acumen, independent decision-making, and the ability to take full ownership of projects with limited direction. The role focuses heavily on revenue recognition, technical accounting, internal controls, accounting systems, financial reporting, and cross-functional project management.

Experience Desired: Coding experience preferably in Medicare Advantage, Risk Adjustment/HCC Coding (1+ yrs); Advanced level of knowledge of ICD-10-CM, CPT, Modifiers & HCPCS coding classification and guideline (3+ yrs); eClinical Works Practice Management System (eCW) (2 yrs)

Required Minimum Education: High School Diploma or equivalent

Required Certifications/Licenses: Coding certification required from AAPC or AHIMA Professional Coding Association

Preferred Certifications/Licenses: CRC (Certified Risk Adjustment Coder) preferred
**C2C is not available**

Job Description

Required Education:

• High School Diploma (or higher)

Required Certifications/Licenses

• Coding certification required from AAPC or AHIMA Professional Coding Association: (CPC, CPC-H, CPC-P, RHIT, RHIA, CCA, CCS, CCS-P etc.) Certification Must Be Current.

Preferred Certifications/Licenses

• CRC (Certified Risk Adjustment Coder)

Required Qualifications:

• Preferably with experience in CMS HCC Risk Adjustment Model; Medical Record Review Provider Documentation Validation

• 3+ years of coding experience, preferably in Medicare Advantage, Risk Adjustment/HCC Coding.

• Advanced level of knowledge of ICD-10-CM, CPT, Modifiers & HCPCS coding classification and guidelines

• Advanced level of knowledge of medical terminology, disease process, and anatomy and physiology

• Must be task-oriented and able to meet designated deadlines and productivity standards

• Experience with eClinical Works Practice Management System (eCW)

Preferred Qualifications:

• Experience with eClinical Works Practice Management System (eCW)

Responsibilities:

• Certified Medical Coder, responsible for accurate coding of the professional services (diagnoses, procedures, and modifiers) from medical records in multi setting (Clinic, Outpatient /InPatient Facilities).

• Apply understanding of relevant medical coding subject areas (e.g., diagnosis, procedural, evaluation and management, ancillary services) to assign appropriate medical codes

• Apply understanding of basic anatomy and physiology to interpret clinical documentation and identify applicable medical codes

• Identify areas in clinical documentation that are unclear or incomplete and generate queries to obtain additional information

• Follow up with providers as necessary when responses to queries are not provided in a timely basis

• Utilize medical coding software programs or reference materials to identify appropriate codes

• Apply post-query response to make final determinations

• Apply relevant Medical Coding Reference, Federal, State, and Professional guidelines to assign and record independent medical code determinations

• Manage multiple work demands simultaneously to maintain relevant productivity and turnaround time standards for completing medical records (e.g., charts, assessments, visits, encounters)

• Resolve medical coding edits or denials in relation to code assignment

• Provide information or respond to questions from medical coding quality audits

• Educate and mentor others to improve medical coding quality

• Demonstrate basic knowledge of the impact of coding decisions on revenue cycle

• Other duties as assigned

• **Only those lawfully authorized to work in the designated country associated with the position will be considered.**
• **Please note that all Position start dates and duration are estimates and may be reduced or lengthened based upon a client’s business needs and requirements.**