100% Remote position for NJ, NY, CT, DE, PA state of candidate.

• About the Role: We are seeking a Senior Professional Coder to join our team and provide services for code abstraction using the Official Coding Guidelines for ICD-9-CM/ICD-10-CM.
• The Senior Professional Coder will be responsible for activities related to Commercial Risk Adjustment, Medicare Advantage Risk Adjustment, Commercial IVA, and Medicare RADV. This role requires maintaining a minimum accuracy of 95% on coding quality audits.
• Responsibilities: Compile chart review findings statistics, analyze data results, and implement action plans to improve providers’ performance levels
• Educate new staff on high-quality data abstraction and chart reviews
• Develop quality assurance processes to ensure data integrity of all submitted diagnoses
• Evaluate and improve risk adjustment coding programs, policies, and procedures
• Work closely with inter departmental team management to support coding initiatives
• Act as a Subject Matter Expert to identify opportunities for business growth
• Educate management on current changes in regulations/guidance related to ICD-10 coding
• Collaborate with operations and clinical leadership to identify coding and documentation improvements - Conduct mock audits targeting problematic diagnoses
• Review medical records for accuracy and compliance with coding guidelines
• Education Qualification: Current Registered Health Information Technologies (RHIT) or Certified Professional Coder designation from the American Academy of Professional Coders or a Certified Coding Specialist from the American Health Information Management (AHIMA)
• Bachelor's degree required Required Skills: 5+ years of Medical Coding experience
• 5+ years of experience in Health Insurance/quality chart audits and/or Utilization Review
• Proficiency in CPT-4, HCPC, ICD-9/ICD-10 coding
• Knowledge of medical terminology, procedures, abbreviations, and terms
• Familiarity with the health care delivery system
• Ability to utilize a personal computer and relevant software