Job Description

Professional, Coding Auditor

Headquarters Office, 625 State Street, Schenectady, New York, United States of America * Rochester, NY, USA

• Tarrytown, NY, USA Req #1614

Wednesday, July 12, 2023

Over 35 years strong and fueled by 1,700 smart, passionate employees across New York state and Vermont, MVP is full of opportunities to grow. We are a nationally recognized, award-winning leader for a reason. The beating heart of our company is a wide range of employees from a diverse set of backgrounds-tech people, numbers people, even people people-working together to make health insurance better. If you are ready to join a thriving, mission-driven company where you can create your own opportunities and make a positive difference-it\'s time to make a healthy career move to MVP!

Status: Full Time, Exempt

Audits Coding Team members work to ensure coding compliance and appropriate reimbursement from CMS and NYS, and adherence to coding policies. Assists Risk Mitigation Coordinators and the Audit Team Leader in providing coding education to the Coding Staff as it pertains to Hierarchical Condition Categories (HCC) for Medicare, Commercial and Medicaid lines of business. Works with internal and external customers to ensure success in the Medicare Advantage, Exchange Risk Adjustment and Medicaid Risk Adjustment payment models. Performs audits of vendor coding and data files as well as assists in Governments Audits as needed. Performs other duties as assigned.

POSITION QUALIFICATIONS

Minimum Education:

RHIT - Registered Health Information Technologist or CPC - Certified Professional Coder or CCS - P - Certified Coding Specialist (Physician) required.
CRC - Certified Risk Adjustment Coder preferred.
Bachelor\'s Degree preferred or Associates Degree with 2 years additional experience required.

Minimum Experience:

1-2 years coding experience for physicians required.
Risk Adjustment experience preferred.
2 years nursing preferred.

Required Skills:

• Excellent facilitation and presentation skills.
• Familiarity with physician coding and billing.
• Excellent oral and written communication skills.
• Detail oriented with high degree of accuracy.
• Ability to exercise discretion in handling confidential information
• Proficiency with Microsoft Word, Excel and PowerPoint or comparable software required. Proficiency with FACETS required within six months from date of hire.
• Demonstrated organizational and coordination skills.
• Ability to multi-task
• Ability to work independently and as a member of a team.
• Ability to defuse difficult interpersonal situations.
• Valid NYS driver\'s license and access to a vehicle. Travel may be required.

About MVP
MVP Health Care is a nationally recognized, not-for-profit health insurer caring for more than 700,000 members in New York and Vermont. Committed to the complete well-being of our members and the communities we serve, MVP makes health insurance more convenient, more supportive, and more personal. We are powered by the ideas and energy of more than 1,700 diverse, employees from all backgrounds, committed to having a positive impact on the health and wellness of everyone we serve. MVP Health Care is an Affirmative Action/ Equal Employment Opportunity (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), and the Know your Rights protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at hr@mvphealthcare.com

Please apply and learn more - including how you may become a proud member of our team.

Other details

• Job Family Medical Management/Clinical
• Pay Type Salary

MVP Health Care