Certified Profession Coder - CPC

Overview

Hybrid
Depends on Experience
Contract - W2
Contract - 3 Month(s)
No Travel Required

Skills

CPC certification
medical coding
healthcare claims
CPT
ICD 10

Job Details

Vega is hiring! We are staffing an CPC / Medical Coder to join our clients CPC team to review Provider/ Physician Claims.

Prefer candidates located in the Wash DC area.

The candidate will serve as an internal expert to ensure that as value-based reimbursement and medical policy models are developed and implemented. Provides advanced knowledge to support effective partnership with provider entities and guidance on the appropriate quality measure capture and proper use of CPT and ICD 10 codes in claims submissions.

Utilizes extensive coding knowledge, combined with medical policy, credentialing, and contracting rules knowledge to help build the effective guides and resources for providers on the expected methodologies for billing and code submissions to maximize quality and STARs outcomes while not compromising payment integrity.

Consults on proper coding rules in value-based contracts to ensure appropriate quality measure capture
and proper use of CPT and ICD10 codes. Provides input on various consequences for different financial and incentive models. Supports to use of alternatives and solutions to maximize quality payments and risk adjustment. Translates from claim language to services in an episode or capitated payment to articulate inclusions and exclusions in models.

Job Requirement:

  • Must have 3+ years experience of reviewing provider claims with medical records for a healthcare provider.
  • Must have a strong back ground ensuring properly coded claims in accordance with AMA, industry standards, and identification of FWA indicators.
  • Must have Accreditations certifications such as CPC, CPMA, COC through AAPC.

If you have the required CPC certification, please select "Apply Now" and a Vega Staffing Specialist will reach out to you.

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