Medical Coding Auditor - Profee Coding, HealthCare

The Finance Operations organization works with every part of Amazon to provide operations accounting and operations excellence services with the highest level of controllership at the lowest cost to the company. We provide the backbone systems and operational processes which completely, accurately, and validly pay Amazon’s suppliers, invoice our customers and report financial results. Amazon is quickly building the Finance Operations capabilities in the healthcare industry by creating the Healthcare Finance Operations Services. As part of the Amazon Healthcare Global Finance Operations Services team, you will find yourself working with exceptionally talented and determined people committed to driving financial improvement, scalability, and process excellence. To support the growth of Amazon HealthCare, this candidate must possess a strong passion for accountability, setting high standards, raising the bar, and driving results through constant focus on improving existing and future state operations, systems, and processes in collaboration with Management.

As we continue to grow and scale our ability to provide innovative primary care across the country, the teams that support this critical work are growing as well. Amazon Healthcare is seeking to hire Medical Coder - Quality Analyst for the Revenue Cycle team. As a member of the Revenue Cycle team, the Medical Coder - Quality Analyst will be leading Manila's One Medical’s Coding's Quality Program.

This position is office-based in Pasay City.


Key job responsibilities
Key job responsibilities as a Quality Analyst (but are not limited to):

• Lead training initiatives such as training materials creation and training needs analysis.

• Conduct process trainings via leading or supplementing training topics for specific processes.

• Auditor will have to conduct spot checks on a monthly basis based on existing quality parameters.

• Provide progress reports to leadership teams regarding quality results and action items on quality misses.

• Discuss results of audits on a monthly basis.

• Analyze and monitor trends and root causes on audit observations.

• Participate in special projects as requested by Leadership.

• Provide inputs or recommendations for quality opportunities and action plans.

Key job responsibilities as a Coding:
• Managing multiple coding related projects and ensuring deliverables are up to One Medical standards while being turned around in an acceptable time frame.

• Remaining current on CPT, ICD-10-CM coding guidelines, AHA Coding Clinic Guidance and CMS Risk Adjustment guidance (as needed).

• Assign appropriate ICD-10-CM, CPT, and other relevant codes to office visits, procedures, and diagnoses in a production environment.

• Responsible for the review and completion of email requests in a timely manner as well as reviewing.

• Work collaboratively with the Medicare Risk Operations team to ensure positive program outcomes.

BASIC QUALIFICATIONS

- Completed Bachelor's Degree
- CPC certification through AAPC and/or CCS certification through AHIMA is required
- 1+ year as an outpatient and/or risk adjustment coder
- Demonstrates knowledge of health systems operations, including an understanding of reimbursement methodologies and coding conventions
- Demonstrates the ability to perform accurate and complete chart reviews for HCC risk Adjustment
- Possess advanced knowledge and understanding of HCC risk adjustment, coding, and documentation requirements.
- Previous experience in a coding production environment.

PREFERRED QUALIFICATIONS

- 1+ year as an outpatient and/or risk adjustment auditor
- 1+ year experience in Medicare/Medicare Advantage
- A CRC license must be obtained within one year of hire (to be sponsored)
- Must have strong experience in Microsoft or Google Suite in spreadsheets and PowerPoint
- Works effectively and efficiently within a team environment.
- Adaptable to shifting priorities and demonstrates willingness to do what it takes to meet client and team needs.
- Complies with policies and procedures for the confidentiality of all patient records and the security of systems.
- Ability to work independently and meet quality of work and workload expectations
- Ability to manage multiple projects • Strong written, verbal, communication, and attention to detail skills.
- Strong organizational, analytical, problem-solving, and time management skills.

Our inclusive culture empowers Amazonians to deliver the best results for our customers.