We believe all seniors regardless of means deserve concierge primary care & wellness, without the concierge fees. They’ve earned it.
Sage Health builds enriching neighborhood health centers that are easy to access, provide or arrange for all of our patients’ healthcare needs, and partner with Medicare Advantage plans that fully cover primary care. Unlike other physician practices, a Sage Health physician has a patient panel of 400 or less, and we collaborate with the best outcomes-oriented specialists and hospitals in each market. Because we are not a fee-for-service provider and manage patients within a global capitation budget provided by Medicare Advantage plans, our only concern and motivation is to keep our seniors healthy.
Sage Health is a destination for the best risk provider talent in the country who are building the new standard-bearing senior model for the United States.
All applicants are considered for all positions without regard to race, religion, color, sex, gender, sexual orientation, pregnancy, age, national origin, ancestry, physical/mental disability, medical condition, military/veteran status, genetic information, marital status, ethnicity, citizenship or immigration status, or any other protected classification, in accordance with applicable federal, state, and local laws. By completing this application, you are seeking to join a team of hardworking professionals dedicated to consistently delivering outstanding service to our customers and contributing to the financial success of the organization, its clients, and its employees. Equal access to programs, services, and employment is available to all qualified persons. Those applicants requiring an accommodation to complete the application and/or interview process should contact team@sage.health.
Company Perks
Join a growing company with a community focused mission to make a difference in the lives of seniors!
Medical, Dental and Vision benefits with generous employer provided contributions to offset per paycheck premium costs.
3 different medical plan options to provide flexibility to meet personal needs including: 2 PPO options and a CDHP plan that includes a $500/year HSA employer match
Healthcare & Dependent Care Flexible Savings Accounts (FSAs)
Access to Employee Assistance Program (EAP) for personal support and work-life benefits.
Employer-paid Life Insurance, Short-term and Long-term Disability benefits. Optional voluntary life insurance is also available.
A 401k retirement plan offered through Transamerica for long-term financial savings & planning.
Flexible time off including: PTO, 7 paid company holidays and 2 floating holidays.
Opportunities for career growth and advancement within the company.
About The Role
POSITION SUMMARY
The Medical Coder will work with office physicians and corporate staff across the organization to identify opportunities for improved quality, risk adjustment HCC coding, and ensuring the documentation is complete and accurate in every patient’s medical chart. The Medical coder will translate clinical diagnosis and procedures for timely recommendation to physicians into their correct alphanumerical codes. Finally, the individual will conduct and collaborate with internal and external audits providing feedback and education to the field team regarding documentation needs and requirements.
What You'll Do
PRIMARY RESPONSIBILITIES
Review and interpret medical record documentation to identify pertinent diagnosis and procedures to accurately recommend ICD-10 CM and CPT codes that reflect the highest level of specificity based on physician documentation.
Verify and ensure the accuracy and completeness of every encounter for appropriate ICD-10 CM, CPT, CPT II codes, in addition to the legibility of documentation and valid signature requirements.
Communicates proactively and timely any problems and opportunities that surface for a better coding process to corresponding physicians, compliance, or any other supervisory role.
Understand and applies the pertinent medical coding guidelines including: the ones established by the organization of coding (OCG), NCQA, federal, state and professional ones.
Conducts internal and external coding quality audits, like the risk adjustment data validation (RADV), providing the necessary and timely information to accomplish a comprehensive coding review.
Assists in the identification and reversal of any coding inaccuracies through claim reversal or a coding deletion process set by the insurance companies
Supports and collaborates with the medical organization to communicate feedback and provide education to physicians on coding best practices. Helps in identifying coding patterns and trends that require such training.
Occasionally attends physician meetings to listen and suggest coding best practices.
Responsible for meeting established quality and productivity standards.
Responsible for training new coding team members on enterprise systems and keeping current on all coding guidelines as established by the AMA.
Qualifications
KNOWLEDGE, SKILLS, AND ABILITIES
In-depth understanding of Medicare Risk Adjustment, HCC coding guidelines and compliance requirements.
Knowledge and understanding of ICD-10 CM, CPT, CPT II (HCSPCS) codes.
Strong communication skills and ability to converse and collaborate with clinicians and other medical professionals.
Should possess the necessary skills to identify trends, inconsistencies and inaccuracies relating to CMS risk adjustment guidelines.
Ability to navigate an electronic health record (EHR), preferably Athena, and other company systems to collect pertinent medical information.
Ability to work independently and remotely.
Basic level of MS Office products (Outlook and Excel)
Ability to learn and navigate payer portals to submit supplemental information for compliance.
Ability to travel within the US (5-10% travel time)
Qualifications
Medical coding credentials required: Certified Professional Coder (CPC), Certified Risk Coder (CRC), or Certified Coding Specialist (CCS, CCS-P).
1+ years of experience in outpatient/clinic-based coding.
Familiarity or experience with value-based care and/or risk adjustment a plus
High school diploma or general education degree (GED).
Physical Requirements
Primary Duty
Percent of Time Performing Duty
Visual Acuity
YES
50-74%
Hearing
YES
25-49%
Standing
NO
0-24%
Walking
NO
0-24%
Lifting/Pulling/Pushing
NO
0-24%
Sitting
NO
0-24%
Seniority level
Entry level
Employment type
Full-time
Job function
Health Care Provider
Industries
Hospitals and Health Care
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