Coder, Medical Billing and Coding, Healthcare Administration

Overview

It's an exciting time to join the Well Sense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances.

The Coder manages the day to day responsibilities of chart abstraction, vendor auditing and reporting in accordance with state and federal regulations. The coder will abstract from in-patient and out-patient medical records and record findings via electronic data base and or excel spread sheets. The coder ensures that all claims accurately reflect the appropriate diagnosis information as outlined in the member's medical record.

• Full-time remote work
• Competitive salaries
• Excellent benefits

• Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10-CM codes are accurately assigned and supported by clinical documentation.
• Ability to code government and state models. This includes code everything projects.
• Maintain current knowledge of ICD-10-CM codes, CMS documentation requirements, and state and federal regulations.
• Ability to maintain a 95% accuracy rate on all coding projects.
• Coders assist with code abstraction and coding quality audits using the Official Coding Guidelines for ICD-9-CM/ICD-10-CM, AHA Coding Clinic Guidance, and in accordance with all state regulations, federal regulations, internal policies, and procedures.

• Current core coding credentials through AHIMA or AAPC (RHIT, CCS, CCS-P, CPC, CIC, etc.) The AAPC CRC (Certified Risk Adjustment Coder) coding certification is highly recommended.
• Strong organizational skills
• Technical savvy with high level of competence in basic computer skills, Microsoft Outlook, Word, Excel and Outlook.
• Strong written and verbal communication skills
• Ability to work independently in a remote environment
• Private lockable office space to ensure security of Member PHI
• Minimum of 5 years coding experience with at least 3 of those years in Risk Adjustment coding.
• Completion of an accredited medical coding program with current unencumbered credentials.

• CPC Certification

• Risk Adjustment coding: 3 years
• Coding: 5 years

General supervision is received weekly

$ 22.36- $32.45

This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, skills, and certifications/licensure as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. In addition, Well Sense offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), merit increases, Flexible Spending Accounts, 403(b) savings matches, paid time off, career advancement opportunities, and resources to support employee and family wellbeing.

Note:
This range is based on Boston-area data, and is subject to modification based on geographic location.

Well Sense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, Well Sense provides high-quality health plans and services that work for our members, no matter their circumstances. Well Sense is committed to the diversity and inclusion of staff and their members.

Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status. Well Sense participates in the E-Verify program to electronically verify the employment eligibility of newly hired employees