MRA Coder

Billing · Sunrise, Florida
Department Billing
Employment Type Full-time

POSITION OVERVIEW:


Responsible for reviewing medical records and identifying, collecting, assessing, monitoring and documenting claims and encounter coding information as it pertains to Clinical Condition Categories.




ESSENTIAL FUNCTIONS AND RESPONSIBILITIES (including, but not limited to):


  • Performs on-site and remote clinical validation audits and interpretation of medical documentation to ensure capture of all relevant coding in coordination with the physician.
  • Verifies and ensures the accuracy, completeness, specificity and appropriate coding based on CMS HCC categories.
  • Analyses and translates medical and clinical diagnoses, procedures, injuries, and  illnesses into designated numerical codes.
  • Reviews medical records, patient medical history and physical exams, physician orders, progress notes, consultation reports, diagnostic reports, operative and pathology reports, and discharge summaries.
  • Performs ongoing analysis of medical charts for appropriate coding compliance.
  • Ensures compliance with all applicable Federal, State, and/or County laws and regulations related to coding and documentation guidelines.
  • Communicates with co-workers, management and clinic staff regarding reimbursement issues.
  • Provides support and compliance with each HEDIS specification through effective communication and training/education.
  • Maintains established departmental policies and procedures, objectives, safety, environmental, and infection control standards.
  • Participates in departmental and organizational quality management activities.
  • Cooperates with other personnel to achieve department objectives and maintain good employee relations, and interdepartmental objectives.
  • Attends departmental meetings as required.
  • Effectively manage special projects and other tasks as assigned.
  • Performs other duties as required.



REQUIREMENTS (including, but not limited to):


  • Ability to travel to several sites located in Miami-Dade, Broward, and Palm Beach county on a daily basis.
  • Associate's Degree or equivalent training or experience required.
  • Minimum, two (2) years experience in a physician practice or in a Medical Center required.
  • Proficient in ICD-10 coding and strong knowledge of ICD-9 and CPT coding.
  • Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision.
  • Must be a reliable team player committed to working in a quality and customer centric environment.  Will require daily interaction in person, on the phone, and via email in order to perform the job.
  • Superior customer service skills: demonstrate responsiveness, depth of knowledge and thoroughness in handling and responding to inquiries from patients and team members.
  • Skilled in harmoniously working in high stress situations/environments and with distraught or agitated individuals.
  • Ability to work autonomously, to multi-task, and provide quality patient care is essential.  
  • Self-reliant and self-motivated with strong ability to prioritize and plan to get things done.
  • Ability to work productively, cohesively within a team and resolve conflict in a positive manner.
  • Adaptability is essential to manage the needs of a department with unpredictable volume and resources.
  • Exceptional interpersonal skills, flexible, outgoing, with a professional “can-do” attitude.
  • Excellent listening comprehension, oral communication, and written communication skills and the ability to interact in a tactful and positive manner.
  • Able to follow oral and written instructions precisely and keen attention to detail and high degree of accuracy.
  • Able to read, write, and understand English.  Bilingual - Spanish or Creole is a plus.
  • Understanding and experience using EMR software and applications.
  • Proficient computer skills and solid knowledge of Microsoft Office products (Outlook, Excel, Word, etc.).
  • Ability to safely and successfully perform the essential job functions consistent with the ADA and other federal, state and local standards, including meeting qualitative and/or quantitative productivity standards.




In addition to the above listed minimum requirements, candidates who possess the following skills, experience, and capabilities may receive greater consideration during the evaluation process:


  • Experience in Geriatrics
  • Experience with a health plan/health insurer and/or Medicare/Medicaid

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  • Location
    Sunrise, Florida
  • Department
    Billing
  • Employment Type
    Full-time