Clinical Quality Coder II, Work from Home

About the position This position conducts review of outpatient medical records using International Classification of Disease Coding ICD-10-CM and Current Procedural Terminology (CPT), Medicare Advantage, ICD-10-CM, and Centers for Medicare and Medicaid Services (CMS) coding and reporting guidelines. Performs medical record reviews to ensure accurate assignment of medical diagnoses and procedures. Responsible for pre-appointment review of each encounter in scope, including Medicare Advantage encounters, to ensure accurate reporting of diagnoses and to alert the physician of potential clinical conditions that may require review. Responsibilities • Conduct review of outpatient medical records using ICD-10-CM and CPT coding guidelines. • Perform medical record reviews to ensure accurate assignment of medical diagnoses and procedures. • Conduct pre-appointment review of each encounter to ensure accurate reporting of diagnoses. • Alert physicians of potential clinical conditions that may require review. Requirements • High School Diploma or equivalent education/experience. • CRC-Certified Risk Adjustment Coder OR CPC-Certified Professional Coder OR AHMA OR AAPC Coding Certification (CCS-P, CPC, COC or CPC-P). • 1 year professional coding experience. Nice-to-haves • Advanced knowledge of ICD-10 diagnosis coding conventions and requirements. • Knowledge of Quality Coding Program requirements such as the Medicare Advantage Coding Program/HCC. • Proficient use of grouper software and/or coding reference books to assign/validate diagnosis codes. • Familiarity with National Correct Coding Initiative edits, Coding Clinic and CPT Assignment coding guidelines. Benefits • Comprehensive benefits package offered by Sutter Health. Apply tot his job