Sr Specialist, Coding (Remote)

Molina Healthcare • Albany, NY • 1w ago

Job Description

Job Summary

Develops, recommends and implements controls and cost-effective approaches to minimize the organization's risks effects. Identifies and analyzes potential sources of loss to minimize risk and estimates the potential financial consequences of an occurring loss. Through the proper combination of casualty and liability insurance, ensures that the provider organization is adequately protected against financial loss.

Knowledge/Skills/Abilities

Performs on-going chart reviews and abstracts diagnoses codes under the HCC Model.

Develops an understanding of current billing practices in provider offices to ensure that diagnoses codes are submitted accordingly.

Documents results/findings from chart reviews and provides feedback to management, providers, and office staff.

Creates necessary tools (educational materials, newsletters, etc.) for providers to assist them in Risk Adjustment.

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.

Provides overall coding expertise and administrative technical oversight to ensure successful integration of departmental initiatives..

Job Qualifications

Required Education

Associates Degree or equivalent work experience

Required Experience

3-5 years

Coding & medical record chart review in a healthcare setting

Required Li

Required License, Certification, Association

Active and unrestricted Coding Certification, Active CCS, CCS-P, or CPC credential

Preferred Education

Bachelor's Degree in Business, Health Care or related field

Preferred Experience

Familiar with HCC (Hierarchical Condition Category)

Preferred Li

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: $77,969 - $128,519 / ANNUAL

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

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