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MO
Sr Specialist, Coding (Remote)
Molina HealthcareAZ, United States, United StatesRemotefull_timeVerifiedPosted 10 Apr 2025
About the role
Job Description
Job Summary
Develops, recommends and implements controls and cost-effective approaches to minimize the organization's risks effects. Identifies and analyzes potential sources of loss to minimize risk and estimates the potential financial consequences of an occurring loss. Through the proper combination of casualty and liability insurance, ensures that the provider organization is adequately protected against financial loss.
Knowledge/Skills/Abilities
• Performs on-going chart reviews and abstracts diagnoses codes under the HCC Model.
• Develops an understanding of current billing practices in provider offices to ensure that diagnoses codes are submitted accordingly.
• Documents results/findings from chart reviews and provides feedback to management, providers, and office staff.
• Creates necessary tools (educational materials, newsletters, etc.) for providers to assist them in Risk Adjustment.
• Provides training and education to network of providers on how to improve their risk adjustment knowledge as well as provide coding updates related to Risk Adjustment.
• Provides overall coding expertise and administrative technical oversight to ensure successful integration of departmental initiatives..
Job Qualifications
Required Education
Associates Degree or equivalent work experience
Required Experience
3-5 years
Coding & medical record chart review in a healthcare setting
Required Li
Required License, Certification, Association
Active and unrestricted Coding Certification, Active CCS, CCS-P, or CPC credential
Preferred Education
Bachelor's Degree in Business, Health Care or related field
Preferred Experience
Familiar with HCC (Hierarchical Condition Category)
Preferred Li
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Job Summary
Develops, recommends and implements controls and cost-effective approaches to minimize the organization's risks effects. Identifies and analyzes potential sources of loss to minimize risk and estimates the potential financial consequences of an occurring loss. Through the proper combination of casualty and liability insurance, ensures that the provider organization is adequately protected against financial loss.
Knowledge/Skills/Abilities
• Performs on-going chart reviews and abstracts diagnoses codes under the HCC Model.
• Develops an understanding of current billing practices in provider offices to ensure that diagnoses codes are submitted accordingly.
• Documents results/findings from chart reviews and provides feedback to management, providers, and office staff.
• Creates necessary tools (educational materials, newsletters, etc.) for providers to assist them in Risk Adjustment.
• Provides training and education to network of providers on how to improve their risk adjustment knowledge as well as provide coding updates related to Risk Adjustment.
• Provides overall coding expertise and administrative technical oversight to ensure successful integration of departmental initiatives..
Job Qualifications
Required Education
Associates Degree or equivalent work experience
Required Experience
3-5 years
Coding & medical record chart review in a healthcare setting
Required Li
Required License, Certification, Association
Active and unrestricted Coding Certification, Active CCS, CCS-P, or CPC credential
Preferred Education
Bachelor's Degree in Business, Health Care or related field
Preferred Experience
Familiar with HCC (Hierarchical Condition Category)
Preferred Li
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
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