Medical Coder Jobs

About Us

Founded in 1973, O’Neil Digital Solutions (ODS) is a leading IT consulting firm specializing in the optimization of complex end-to-end business process systems for a multitude of business verticals including Financial Services, Digital Media, Healthcare, and Transportation industries. ODS provides high-touch bespoke software engineering, systems integration, and infrastructure management services to clients of all sizes and industries. From large scale mass communication projects to highly secure and confidential data analytics using Big Data frameworks like Hadoop and AWS Redshift, ODS has a broad set of proven technical capabilities that help companies make complex digital transformations. ODS offers state of the art publishing solutions through our customer-centric applications and services include electronic document delivery, web applications, high-speed digital printing (color and black & white), automated composition, offset printing, warehousing and fulfillment services. ODS is headquartered in Los Angeles, CA and also has offices/plants in Texas and North Carolina centrally located to serve clients across the country.

Summary

In this role, the Medical Coder will leverage their healthcare industry experience/knowledge to support ODS in its Product Development. The Medical Coder will document all applicable components of the claims lifecycle and provide insight and define all the necessary formulas and data components related to HCC codes, and ICD-10 codes. The Medical Coder will facilitate the business objectives of particular use cases and define all parameters, constraints, and opportunities.

Compensation

Targeted Hiring Range: $19.00/hour - $25.00/hour (non-exempt)

Pay ranges are open to negotiation depending on the nature of the role and additional compensation plans such as commissions and bonuses are not factored in.

Duties and Responsibilities

• Detail key metrics applicable to Claims department(s)
• Detail key metrics applicable to Risk Adjustment department(s)
• Serve as subject matter expert on topics including but not limited to HCC codes, ICD-10 codes, claims
• Document critical formulas used by MCO’s in health risk assessments
• Articulate end-to-end claims process and provide requirements to development team
• Identify gaps in current state processes and make recommendations for product enhancements
• Provide detailed description of how Risk Adjustment departments function

Qualifications & Requirements

• Knowledge of ICD-10 coding guidelines
• 2 years (Required) Prior experience working within a MCO (Managed Care Organization) Claims/Risk Adjustment/Quality Department
• Knowledge of medical terminology and diagnostic codes
• Knowledge of billing applications
• Knowledge in computer hardware and software use
• Knowledge of HCC codes + ICD-10 codes and associated formula for assessing risk
• Proficient in getting an accurate insurance benefits
• Proficient in Explanation of Benefits (EOB’s) and knowledge of CPT codes
• Must have a strong understanding of PPO/HMO insurance products and the associated claims process, and Medicare rules and regulations with regards to Risk Adjustment
• Reliable, punctual, and trustworthy

Preferred Education, Experience, Certification/Licensure

• Medical Coding: 2 years (Required)
• AAPC Certification (Required)

Working Conditions

Office / Sedentary Requirements
Must be able to perform the essential job duties. Work is performed primarily in an office environment. Typically requires the ability to sit for extended periods of time (66%+ each work day), ability to hear the telephone, ability to enter data on a computer and may also require the ability to lift up to 10 pounds.

Equal Opportunity Employer

O'Neil Digital Solutions is an equal opportunity employer. All aspects of employment including the decision to hire, promote, discipline, or discharge, will be based on merit, competence, performance, and business needs. We do not discriminate on the basis of race, color, religion, marital status, age, national origin, ancestry, physical or mental disability, medical condition, pregnancy, genetic information, gender, sexual orientation, gender identity or expression, veteran status, or any other status protected under federal, state, or local law.