“Sanitas is a global healthcare organization expanding across United States. Our services include primary care, urgent care, nutrition, lab, diagnostic, health care education and resources for our patients. We strive to attract professionals who believe in our mission, vision and are dedicated to the service of our patients and their families creating a memorable experience through compassion, respect, and kindness.”

Job Summary

The Coding Specialist I is responsible for coding all medical services procedures CPT and HCPCS codes, pharmaceutical supplies, patients’ ICD-10 diagnoses, signs, and symptoms when applicable, ensuring that all assigned ICD-10-CM codes are supported by proper clinical documentation. This position will be reporting directly to the Risk Adjustment Manager and the Risk Adjustment and Quality Sanitas USA director.

Essential Job Functions

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Utilizes ICD10 CPT and HCPCS codes for reporting diagnosis and procedures. Maintains performance and quality by conducting ongoing audits of physicians and mid-level providers’ medical records. Assigns all potential HEDIS-allowable codes for appropriate services to be captured. Ensures progress notes are coded accurately and to the highest level of specificity following established coding guidelines. Ability to abstract valid codes from hospital claims data and outpatient providers. Maintains productivity goals set by the department. Always maintains patient’s confidentiality, according to legal requirements and privacy laws. Follows established policies and procedures. Queries the physician for clarification and to obtain accurate and complete documentation as needed. Provides feedback to Supervisor regarding any coding issues. Supports ongoing review and query process to ensure that any amendment occurs in a timely and compliant manner. Attends departmental meetings as required. Cooperates with other personnel to achieve department objectives and maintain good employee relations, and interdepartmental objectives. Effectively manage special projects and other tasks as assigned. Ensure that any amendment occurs in a timely and compliant manner. Educates providers on HCC Coding and clinical documentation requirements related to risk adjustment.