Medical Coding Analyst - CarePoint

Medical Coding AnalystSan Juan, PRABOUT US

At Grupo Triple S, we are committed to provide meaningful job experiences for Valuable People (Gente Valiosa). We encourage an environment of very high ethical standards, always excelling in service, collaboration among the company, agility to deliver timely, and embracing accountability for results.

When you join Grupo Triple S, you will be key to our efforts on delivering high-quality and affordable healthcare as well as contribute to our purpose to enable healthier lives. We serve more than 1 million consumers in Puerto Rico through our Medicare Advantage, Medicaid, Commercial, Life and Property & Casualty Businesses.

Let's build healthier communities together, join now!

ABOUT THE ROLE

Responsible for correctly coding healthcare claims in order to obtain reimbursement from insurance companies and government healthcare programs, such as Medicare. Work to obtain accurate reimbursement for healthcare claims. Review claims data to ensure that assigned codes meet required legal and insurance rules and that required signatures and authorizations are in place prior to submission.

WHAT YOU'LL DO

• Analyze patient charts carefully to know the diagnosis and represent every item with specific codes.
• Reading and analyzing patient records systematically translating medical terminology into unique and professional codes for medical personnel and insurance companies to understand and interpret in the course of carrying out their duties.
• Charged with include rigorously reviewing and evaluating patient health history for them to identify the causes of their illness and determine best treatment to administer to prevent adverse reactions.
• Keeping accurate records of patient illness and treatment and making them available upon request to members of the healthcare team who are also working to improve patient health.
• Collect health information as documented by medical specialists and code them appropriately.
• Advocate for patients where their medical history is needed as evidence.
• Evaluate and re-file appeals of patient claims that were denied.
• Interacting with physicians and assistants to ensure accuracy.
• Keeping track of patient data over multiple visits.
• Managing detailed, specifically coded information.
• Maintaining patient confidentiality and information security.
• Provide accurate answers to queries on coding.
• Consult medical specialists for further clarification and understanding of items on patient charts to avoid any misinterpretations.
• Ensure that codes tally with doctors' diagnosis.
• Promotes policies and procedures following recognized standards of care, accreditation, compliance standards and guidelines, and other evaluating entities, including state and federal agencies.
• Contribute to team effort by accomplishing related results as needed. Participates in proactive team efforts to achieve departmental and company goals.
• Performs other duties as assigned by supervisor.

WHAT YOU'LL BRING

Bachelor's Degree in Business Administration or Health Science with one(1) to three (3) years of experience as a Medical Coder.Certified Coding Specialist from American Health Information Management Association (AHIMA) or the American Association of Professional Coders (AAPC).

CLOSED DATE: 2/27/2024

It is company policy to seek for the qualified applicants for positions throughout the company without distinction of race, color, national origin, religion, gender, gender identity, real or perceived sexual orientation, civil status, social condition, political ideologies, age, physical or mental disability, veteran status or any other characteristic protected by law. Drug-free company.

Equality Employment Opportunity/Affirmative Action for Minorities/Females/People with Disabilities/Veterans". Employer with E-Verify to verify the eligibility of employment of all the new employees.

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