Medical Coder

Job: Professional Coder I

Duration: 6+ Months

Location: Newark, NJ 07105

Pay Rate: $40 - $42/hr on W2

This role is responsible for accurately reviewing, interpreting, auditing, coding, and analyzing medical record documentation for diagnosis accuracy, correct documentation, and Hierarchical Coding Condition (HCC) abstraction. Reviews may include inpatient, outpatient treatment, and/or professional medical services in accordance with ICD-9/ICD-10-CM coding guidelines and risk adjustment model regulations. The position supports Annual Commercial (ACA) and Medicare Advantage Risk Adjustment Data Validation (RADV) audits, along with the annual risk adjustment lifecycle for Medicare, Medicaid, and Commercial lines of business.

Responsibilities

• Understand and translate CPT, HCPC, and ICD-9/ICD-10 codes for HCC abstraction.
• Review medical records for completeness, accuracy, and compliance with applicable coding guidelines and regulations.
• Identify, compile, and code member/patient data using ICD-9/ICD-10-CM and other standard classification coding systems.
• Support the collection and distribution of documentation and coding improvement tools for designated practice units as applicable.
• Support educational activities for internal stakeholders as needed as a subject matter expert on coding review and guidelines.
• Participate in program improvement discussions and activities.
• Maintain department productivity and accuracy standards.