Provides support to the business by making sure proper ICD-10 and CPT codes are reported accurately to maintain compliance and to minimize risk and denials.
Requirements
- Performs on-going chart reviews and abstracts diagnosis codes
- Develop an understanding of current billing practices in provider offices to ensure that diagnosis and CPT codes are submitted accordingly
- Documents results/findings from chart reviews and provides feedback to management, providers, and office staff
- Provides training and education to network of providers on how to improve their risk adjustment knowledge as well as provide coding updates related to Risk Adjustment
- Builds positive relationships between providers and Molina by providing coding assistance when necessary
- Responsible for administrative duties such as planning, scheduling of chart reviews, obtaining of medical records, and provider training and education
- Assists in coordinating management activities with other departments in Molina including Finance, Revenue analytics, Claims and Encounters, and Medical Directors
- Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies
- Contributes to team effort by accomplishing related results as needed
- Other duties as assigned
Benefits
- Competitive benefits and compensation package
Originally posted on Himalayas
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