Job Title: MRA Coder Department: Medicare Risk Adjustment Reports To: Medicare Risk Adjustment Director Location: Miami-Dade & Broward County Status: Full Time Designation: 75% local travel Responsibilities: The MRA Code…
Skills: HCC Coding, ICD-10, CPT Codes, Medical Record Validation, Chart Review
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Full-time
professional certificate
Posted 19d ago
~40 hrs/week
Responsibilities
The MRA Coder coordinates retrospective and concurrent chart reviews using HCC coding to validate medical record data. They are also responsible for educating physicians on documentation policies and ensuring compliance with federal and state risk adjustment regulations.
Requirements
Candidates must hold a professional certification such as CPC, CPMA, or CRC and have at least 3 years of Medicare Risk Adjustment coding experience. Proficiency in Microsoft Excel, ICD-10/CPT codes, and bilingual fluency in English and Spanish are required.
Full job description
Job Title: MRA Coder
Department: Medicare Risk Adjustment
Reports To: Medicare Risk Adjustment Director
Location: Miami-Dade & Broward County
Status: Full Time
Designation: 75% local travel
Responsibilities:
The MRA Coder will be responsible for coordinating/supporting retrospective and concurrent chart reviews using knowledge of Hierarchical Condition Categories (HCC) coding to translate, input, extract and validate medical record data.
Job Duties:
Review patient medical history and physical exams, physician orders, progress notes, consultation reports, diagnostic reports, operative and pathology reports, and discharge summaries in order to verify whether the diagnosis codes are supported by the documentation to ensure they are within Guidelines for Coding and Reporting
Schedule chart reviews with Physician practices
Assist in obtaining medical records from Physicians to support audits requested by Health Plans
Ensure compliance with all applicable Federal, State and/or County laws and regulations related to coding and documentation guidelines for Risk Adjustment.
Educate Physicians regarding proper billing and documentation policies, procedures, and conflicting/ambiguous or non-specific documentation
Demonstrate the ability to quickly identify low risk scores; incorrect coding and compliance trends; to analyze and investigate suspected problems with resolve; and to forward problems to the attention of the Medicare Risk Adjustment Director
Performs other duties as required.
Requirements:
CPC /CPMA/ CRC/ CCS-P/ CCS/ RHIA or RHIT certification
Minimum 3 years of Medicare Risk Adjustment coding
Advanced Microsoft Excel
Familiar with HCC Dashboard tool
Strong knowledge of ICD-10 and CPT codes
Fluent in English and Spanish
Clean driving record and reliable form of transportation
Producing the best medical outcomes at the most reasonable cost
Industry
Hospitals and Health Care
Company size
51-200 employees
Headquarters
Coral Gables, Florida
LinkedIn followers
2,390
Healthcare industry veterans Joe Caruncho – whose success at the helm of Preferred Care Partners led to annual sales in excess of $750 million – and Orlando Lopez-Fernandez, Jr., MD, founded Genuine Health Group to usher in a new era of healthcare delivery focused on value instead of volume.
Today, Genuine Health is building a model for managing care delivery that embodies traditional values, promises reliability, and embraces flexibility and technology. Through its accountable care organization, PremierMD ACO, the company aims to improve healthcare outcomes, achieve cost savings for the care of patients who receive traditional, fee-for-service Medicare benefits, and serve as a single point of contact to move doctors’ Medicare members into value-based care. And, through its management service organization (MSO), the company aims to deliver financial upside for its participating physicians whose patients are enrolled in Medicare Advantage plans.
For both traditional Medicare beneficiaries and those who choose managed care plans, Genuine Health and its providers are demonstrating the powerful effects of value-based care.
Offices: 806 S Douglas Rd, Suite 700, Coral Gables, Florida 33134, US
Producing the best medical outcomes at the most reasonable cost
Industry
Hospitals and Health Care
Company size
51-200 employees
Headquarters
Coral Gables, Florida
LinkedIn followers
2,390
Healthcare industry veterans Joe Caruncho – whose success at the helm of Preferred Care Partners led to annual sales in excess of $750 million – and Orlando Lopez-Fernandez, Jr., MD, founded Genuine Health Group to usher in a new era of healthcare delivery focused on value instead of volume.
Today, Genuine Health is building a model for managing care delivery that embodies traditional values, promises reliability, and embraces flexibility and technology. Through its accountable care organization, PremierMD ACO, the company aims to improve healthcare outcomes, achieve cost savings for the care of patients who receive traditional, fee-for-service Medicare benefits, and serve as a single point of contact to move doctors’ Medicare members into value-based care. And, through its management service organization (MSO), the company aims to deliver financial upside for its participating physicians whose patients are enrolled in Medicare Advantage plans.
For both traditional Medicare beneficiaries and those who choose managed care plans, Genuine Health and its providers are demonstrating the powerful effects of value-based care.
Offices: 806 S Douglas Rd, Suite 700, Coral Gables, Florida 33134, US