Medical Coder

Medical Coder Edifecs is looking for enthusiastic and detail-oriented Medical Coders specialized in HCC Risk adjustment coding. This role is open to experienced professionals with a passion for accuracy and a drive to excel in the field of Medical coding. What you will do:

• Review and analyze patient’s medical records (charts and encounters) for accurate coding
• Abstract and capture of Risk adjustable ICD codes and other relevant information from patient’s Medical records.
• Work on Prospective, Concurrent or Retrospective HCC coding projects in line with CMS’s standard Coding guidelines for Medicare and Commercial health plans.
• Review claims data against medical records for validation and provider documentation gaps.
• Organize and prioritize the work to ensure that medical records are coded in a timely manner with accuracy and in compliance with regulatory and client coding guidelines.
• Compliance with HIPAA polices and procedures for confidentiality of ePHI data.
• Examining documents for missing information.
• Familiarity with the coding systems and code sets, including ICD , CPT , and HCPCS
• Ability to spot inaccuracies or inconsistencies in medical records and ensure precision
• Capacity to interpret and understand complex medical information from patient records
• Ability to work on coding software, and relevant tool to perform medical coding.

What you will bring:

• Bachelor’s degree (or equivalent) in Life science/health information systems or related field.
• 3+ years of work experience as a medical coder
• Knowledge in Human Anatomy, Physiology and familiar with medical terminologies
• CPC or CRC certification that is currently active
• At least 2 years of experience in HCC coding projects
• Strong knowledge in HCC coding guidelines
• Familiar with First pass, Second pass and Claims validation projects
• Familiar with Prospective or Retrospective coding using coding tools/blind coding
• Proficient computer skills.
• Excellent communication skills, both verbal and written.
• Strong people skills.
• Outstanding organizational skills.
• Ability to maintain the confidentiality of information.

About Edifecs Edifecs provides market-leading technology to its payer and health system customers, which serve nearly 300 million people in the U.S. healthcare market. For over 25 years, Edifecs has enabled customers to unlock greater value with their healthcare data management platform which includes its Best in KLAS healthcare interoperability cloud solution. Edifecs’ healthcare SaaS solutions, available on both public and private clouds, serve as the foundation that eliminates stakeholder friction to overcome healthcare’s biggest challenges, including accelerating value-based payment adoption and obtaining more complete and accurate care funding for alternative payment models. Edifecs’ solutions are powered by AI that incorporates generative AI and LLMs, natural language processing, and machine learning, to provide deeper insights into patients, populations, and business processes. As new standards and regulations continually emerge from government agencies, Edifecs is a proven partner to support its customers road to “evergreen” compliance. Edifecs customers include 24 of the 25 top commercial health plans in the country, 29 of the 52 Medicaid programs, and 6 out of 10 of the largest health systems. We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, gender identity or expression, sexual orientation, age, marital status, or disability status. Our corporate credo of innovation, collaboration, customer-centricity, and integrity drive and inform all our actions and decisions. Please contact careers.in@edifecs.com for more information