Associate III - BPM

Responsibilities include, but are not limited to, the following. Review of Charts completed by RA Coders. Able to articulate and discuss issues raised on codes being corrected. Assign appropriate ICD-10-CM codes, mapping to risk adjustment models for Medicare Advantage and ACA Commercial Projects. Assign Flag events and CDI for documentation discrepancies. Comply with the Standards of Ethical Coding as set forth by the American Health Information Management Association and adhere to official coding guidelines. Comply with HIPAA laws and regulations. Maintain quality (=>97%) and production standards as an OR Remain current on diagnosis and coding guidelines and risk adjustment reimbursement reporting requirements. Qualification: With at least 1 year experience as a QA/OR in RA HCC coding experience With at least 3 years medical coding experience (RA) Must be College graduate with at least 5 years of BPO experience. Active coding certification under AAPC or AHIMA, Certified Risk Adjustment Coding Certification (CRC) preferred. Able to code using ICD-10 CM physical codebook or coding software. Strong clinical knowledge related to chronic illness diagnosis, treatment, and management. Computer proficiency (MS Office and internet)