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MRA Coder Analyst

Human Resource Advantage, LLC • Miami, FL

Posted 26 days ago

Job Snapshot

Full-Time
Experience - 1 to 3 years
Insurance
Health Care
9

Applicants

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Job Description

Delivery Network is seeking energetic, talented and qualified professionals to join us in our mission of changing the healthcare experience of our members - making it easier, friendlier and more accessible.  If you are looking for a challenging and rewarding career with a chance to make a real difference in your community, please apply. 

We are headquartered in Miami Lakes supporting the needs of Medicare Advantage recipients throughout South Florida.  We are proud to offer outstanding career advancement opportunities, competitive salaries, paid holidays, medical & dental insurance plans, Paid Time Off, disability benefits, and a 401(k) retirement savings plan.

The MRA Coder Analyst is responsible for accurately translating the diagnoses from patient visits into ICD-10 codes and entering them into the claims system to ensure accuracy and integrity of risk adjustments submitted to CMS. 

Essential Duties & Responsibilities:
  • Abstracts, codes, and reviews the medical record, including medications and diagnostics, to ensure all conditions are captured and monitors ICD-10 codes submitted for Medicare Risk Adjustment to ensure completeness and accuracy.
  • Proficient in assigning ICD-10-CM codes according to provider documentation level to comply with federal regulations and insurance requirements.  
  • Ensures proper code selection for compliance with ICD-10-CM Official Guidelines for Coding and Reporting.
  • Educates physicians on proper documentation and compliance standards. 
  • Reviews medical record to include consultations (inpatient and outpatient) and hospital discharge summaries to ensure continuity of care and continued coding for accurate risk adjustment.
  • Performs audits to ensure medical record completeness, consistency, and compliance. 
  • Identifies, analyzes, and addresses documentation and/or coding discrepancies within the medical record/progress note and the submitted encounter.
  • Queries providers when necessary for proper documentation per CMS Guidelines.
  • Runs outstanding encounter report daily to ensure all services have been coded and encounters have been properly closed.
  • Communicates effectively with other professional and support staff in order to achieve positive customer outcomes.
  • Promotes and contributes to a positive, problem-solving environment.
  • Assists customers, family members and others with concern and empathy; respect their confidentiality and privacy and communicate with them in a courteous and respectful manner.
  • Complies with company policies and procedures and maintains confidentiality of customer medical records in accordance with state and federal laws.
  • Ensures compliance with all HIPAA, OSHA, and other federal, state, and local regulations. 
  • Participates in meetings, training and in-service education, as required. 
  • Performs other duties as assigned.

Job Requirements

  • High school graduate or equivalent and one (1) year of clinical work experience; or equivalent combination of education and experience
  • Certified professional coder with acceptable credentials of AAPC – CPC or COC, and/or AHIMA – CCS credentials required
  • Continuing education in accordance with the accredited credential and maintenance of such certifications
  • Experience using ICD-10-CM codes, CPT codes and modifiers, and HCPCS codes
  • Extensive knowledge of Medicare Risk Adjustment HCC categories
  • Strong knowledge of HEDIS
  • Excellent computer knowledge is required, including proficient knowledge of Microsoft Office. 
  • Strong attention to detail
  • Excellent listening, interpersonal, verbal and written communication skills with individuals at all levels of the organization
  • Ability to work effectively independently and in a team environment
  • Ability to read, analyze, and interpret technical procedures or governmental regulations
  • Ability to write reports, business correspondence, and procedure manuals
  • Ability to effectively present information and respond to questions from groups of managers, clients, customers and the general public
  • Ability to calculate figures and amounts, such as discounts, interest, commissions, proportions, percentages, area and volume
  • Ability to define problems, collect data, establish facts, and draw valid conclusions
  • Strong decision-making and analytical skills
  • Must be self-motivated, organized and have excellent prioritization skills
  • Must be able to work well under stressful conditions
  • Must be able to work in a fast-paced environment
  • Ability to handle multiple job functions and prioritize appropriately
  • Fluency in Spanish and English required
  • Creole speaking preferred

Delivery Network and its affiliated companies is an equal opportunity/affirmative action employer and complies with all federal and state laws, regulations and executive orders regarding affirmative action requirements in all programs.M/F/D/V. 

Delivery Network and its affiliates are also a drug-free workplace.

*Internal candidates must submit the Internal Application Form approved by his/her supervisor before interviewing with HR. Qualified candidates will be considered by the Hiring Manager.
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