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Certified Coder - Remote - Military Veterans

at Molina Healthcare

JOB DESCRIPTION

Job Summary

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.

KNOWLEDGE/SKILLS/ABILITIES

  • 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
  • 2 years previous coding experience
  • Proficient in Microsoft Office Suite
  • Ability to effectively interface with staff, clinicians, and management
  • Excellent verbal and written communication skills
  • Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)
  • Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers, and customers
  • Maintain knowledge in the latest coding guidelines (official through CMS) as well as AHA Coding Clinic guidance

JOB QUALIFICATIONS

Required Education

Associates degree or equivalent combination of education and experience

Required License, Certification, Association

  • Certified Professional Coder (CPC)
  • Certified Coding Specialist (CCS)

Preferred Education

Bachelor's Degree in related field

Preferred Experience

  • Familiar with HCC (Hierarchical Condition Categories) Risk Adjustment Model
  • Background in supporting risk adjustment management activities and clinical informatics
  • Experience with Risk Adjustment Data Validation

Preferred License, Certification, Association

  • Certified Risk Adjustment Coder (CRC)
  • Certified Professional Payer Payer (CPC-P)
  • Certified Coding Specialist Physician based (CCS-P)

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $17.85 - $38.69 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

KY

Molina Healthcare

Molina believes every person, family and community deserves access to high-quality health care regardless of their situation. Our mission is to deliver effective, reliable and affordable health care to those who need it most. We strive to meet the physical, social and emotional needs of each member and to strengthen the communities we serve. 

We do this by offering a holistic, community-based approach designed specifically to meet the individual needs of our members. 

What started in 1980 as one clinic in Long Beach, aimed at addressing the disparities in access to quality health care, has grown into 19 health plans across the country. For over 40-years we’ve been improving the lives of our 5.1 million members across the country by pioneering health care services exclusively for those with government-sponsored health care. 

As our membership has grown over the years, so has our commitment to the communities we serve. In 2020, we launched the MolinaCares Accord, which makes substantial investments to improve members’ access to health care. 

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