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Medical Coder

at Advanced Resources

Posted: 5/31/2019
Job Status: Contract/Temporary
Job Reference #: J3V7XC6K6S6SKL54TL6

Job Description

Specific duties include, but are not limited to the following: 
• Translation of ICD-9 codes to ICD-10 codes.
• Develop business rules via interviews, translation of governing documents and other means. 
• Conduct meetings with personnel and other affected parties impacted by the transition. 
• Serve as team expert on Medical Coding methodologies, Claim Adjudication, Reference, Medicaid Policy and related topics. 
• Research business rules, requirements, and models. 
• Maintain business rules, requirements, and models in a repository. 
• Other project-related duties. 


• 15 years' experience in health care insurance; medical review, program integrity, or appeals. 
• 5 years' experience working with IT developers/programmers in payer environment. 
• 5 years' experience Medical Coding in payer environment. 
• Strong knowledge of ICD-9/ICD-10 translation 
• Extensive knowledge of anatomy, physiology, pharmacology and medical terminology. 
• Strong knowledge of ICD/CPT/HCPCS coding methodologies 
• Superb written and oral communications skills, strong proficiency in English is required. 
• Strong knowledge of formal business process documentation. 
• Ability to effectively communicate to executive management, line management, project management, and team members. 


• Experience in policy remediation. 
• Claims processing systems experience. 
• Knowledge of Microsoft Office (Word, Excel, PowerPoint, Optum Encoder and or other medical coding software programs). 


AHIMA Approved ICD-10-CM/PCS Trainer 
CPC,CCS Coding Certification 

Currently credentialed as CPC (Certified Professional Coder) or as CCS (Certified Coding Specialist). ICD-10 Proficiency demonstrated by exam.

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