Certified Medical Coder - Las Vegas NV

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Job Information

Humana

Certified Medical Coder - Las Vegas, NV

in

Las Vegas

Nevada

Description

The Primary Care Organization (PCO) Medical Coder conducts review of medical records to apply medical codes (ICD10, CPT, CPTII) for professional services that will be submitted to payers. The PCO Medical Coder work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coder assumes ownership and leads advanced and highly specialized administrative & operational support duties that require independent initiative and judgment.

This role requires a thorough understanding of the relationship between codes and revenue in the reimbursement process, specifically how revenue is generated from ICD-10CM, CPT and HCPCS codes. The Primary Carey Organization Medical Coder must maintain current knowledge of regulatory changes that impact documentation, coding and billing practices as well as understanding of clinical operations, coding and billing office workflows.

Responsibilities

CenterWell is seeking a dedicated, compassionate, and experienced - Certified Medical Coder

- who is interested in growing with the company and being a part of something great!

Location

: CenterWell Senior Primary Care office located throughout metropolitan Las Vegas, NV

About CenterWell Senior Primary Care:

CenterWell Senior Primary Care, a subsidiary of Humana Inc., is the new brand for a primary care medical group practice with centers open or opening in Florida, Georgia, Kansas, Louisiana, Missouri, Nevada, North Carolina, South Carolina and Texas. CenterWell Senior Primary Care has a strong emphasis on senior-focused primary care for members of Medicare Advantage health plans and is committed to providing personalized, high-quality primary care combined with an excellent patient experience. CenterWell Senior Primary Care has experience in both the treatment and management of most chronic and acute-care conditions. The practices also provide health education and value-added, well-being services at the centers and around their neighborhoods to help both patients and community members improve their health.

Vaccine Policy:

For this job, associates are required to be fully COVID vaccinated or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are a healthcare company committed to putting health and safety first for our members, patients, associates, and the communities we serve.

If progressed to offer, you will be required to:

Provide proof of full vaccination OR

Commit to weekly testing, following all CDC protocols, OR

Provide documentation for a medical or religious exemption consideration.

This policy will not supersede state or local laws. Requests for these exemptions should be submitted at least 2 weeks prior to your scheduled first day of work.

Certified Medical Coder Role Overview:

Conducts review of medical records to apply medical codes (ICD10, CPT, CPTII) for professional services that will be submitted to payers

Completes work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action

Assumes ownership and leads advanced and highly specialized administrative & operational support duties that require independent initiative and judgment

Maintains a thorough understanding of the relationship between codes and revenue in the reimbursement process, specifically how revenue is generated from ICD-10CM, CPT and HCPCS codes

Maintains current knowledge of regulatory changes that impact documentation, coding, and billing practices

Understands clinical operations, coding and billing office workflows

Conducts medical record reviews to apply quality data and medical codes that are submitted to the Centers for Medicare and Medicaid Services (CMS), payers, and other government agencies.

Ensures coding is accurate and properly supported by clinical documentation within the health record

Follows state and federal regulations as well as internal policies and guidelines while analyzing coding information and medical records

Participates in provider education programs on coding compliance.

Communicates information regarding medical documentation and coding best practices to assigned providers while building relationships with providers and stakeholders

Responds to or clarifies internal requests for medical information

Analyzes, enters and manipulates database

Understands department and organizational strategy and operating objectives

Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed

Follows established guidelines/procedures

Required Qualifications

HS diploma/GED

CPC (Certified Professional Coder) Certification required or AHIMA CCS-P

Strong knowledge of Microsoft Office products (Outlook, Word, Excel, Teams)

Strong written and verbal communication skills; strong analytical, organizational and time management skills

2 years' experience coding in a value based care medical office environment

In-depth knowledge of Medicare/Medicaid regulations, including billing, coding and documentation requirements.

Understanding of the application of authoritative guidance to the interpretation and analysis of documentation, coding, and queries.

Ability to build and maintain effective relationships with internal stakeholders

Demonstrated strong interpersonal communication including a willingness to consistently provide superior customer service and the ability to react with a professional demeanor

Preferred Qualifications

CRC (Certified Risk Coder) Certification

Associate's degree in related healthcare field

eCW experience

Bachelor's degree

Experience in a fast paced, metric driven operational setting

Certified Medical Coder Working hours:

Scheduled 40 hours per week

Monday to Friday 8AM-5PM

Local travel may be required; Mileage is reimbursed

Being a part of the CenterWell team gives you benefits that include:

We offer tangible and intangible benefits such as medical, dental and vision benefits, 401k with company matching, tuition reimbursement, weeks of paid vacation time, paid holidays, work-life balance, growth, a positive and fun culture and much more.

Alert:

Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions to add the information into the application at Humana's secure website.

Interview Format:

To enhance our hiring and decision-making ability. Modern Hire Text allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule.

If you are selected for a first round interview, you will receive an email correspondence inviting you to participate in a Modern Hire text interview. In this interview, you will read to a set of interview questions and you will provide text responses to each question. You should anticipate this interview to take about 15 minutes. Your text interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Language Proficiency Testing:

Bilingual English/Spanish. Must be able to speak, read and write in both languages without limitations or assistance. See Additional Information on testing. ​ Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government.

Equal Employment Employer:

CenterWell Senior Primary Care is more than an equal opportunity employer, CenterWell's dedication to promoting diversity, multiculturalism, and inclusion is at the heart of what we do in all of our CenterWell roles. Diversity is more than a commitment to us, it is the foundation of what we do. We are fully focused on diversity of race, gender, sexual orientation, religion, ethnicity, national origin and all of the other fascinating characteristics that make us each uniquely wonderful.

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com