Certified Medical Coder Job at Randstad USA in Boston

Responsibilities include: Work with SIU Investigators assisting in research, discuss to make appropriate coding determinations as needed Analyze and interpret patient medical records (behavioral related and other specialties) pertaining to FWA investigations as needed Compare information submitted on the claims to determine amount and nature of billable services as needed Determines appropriateness of billing and reimbursement as needed Documents findings for each claim line in a spreadsheet as needed Summarize findings in a written report as needed Abstracts CPT, HCPCS, Revenue Codes, DRG codes, and ICD-10 from medical records as needed Responsible for maintaining current knowledge of coding guidelines and relevant federal and/or state regulations as needed Provide Subject Matter Expertise and SIU support to clients as needed Comply with Privacy and Security standards Understands and complies with all company Privacy and Security standards Other duties as neededKNOWLEDGE, SKILLS, & ABILITIES Knowledge of anatomy, medical terminology, and billing In-depth knowledge of and ability to interpret ICD-10-CM/PCS, HCPCS/CPT, Knowledge of APR-DRG, MS-DRG codes and DRG grouping systems and Plan benefit designs.1-2 years’ experience reviewing and auditing medical records, working in a health plan or health insurance, or similar environment. Ability to identify and abstract information from medical records (paper or electronic) to ensure coding guidelines are met Knowledge of specialty medical practices Must be detail oriented Ability to communicate effectively both verbally and in writing ResponsibleAbility to meet defined performance and production goals Strong computer skills: – proficient in MS Word, Excel, PowerPoint and Outlook, familiarity with Electronic Medical Record systems and Encoders. Consistently meets coding quality standards and thresholdsCERTIFICATE/LICENSE Active Certified coder (RHIA, RHIT, CPC, CPMA, CIC, COC or CCS-P) required; candidate would need to maintain active certification. Finishing Touches (Preferred): Knowledge of Health Insurance, Managed Care, Benefit Design, Medicaid, Medicare Advantage and Federal Regulations. Hands-on work with complex medical and billing information preferred___________________Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status. At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact HRsupport@randstadusa.com.Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).This posting is open for thirty (30) days. It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.