American Association of Clinical Coders & Auditors
Now is the Time to Add ICD10 Coding, 
Documentation Review and
Revenue Integrity to your
Nursing Career!


Job Opportunities


R.N. Coding Specialist / Nurse Auditor

Atlanta, Georgia

Company

 

At Vatica Health we are on a Mission to improve the quality of healthcare and keep populations healthy at a lower cost. We innovate and deliver scalable, end-to-end technology solutions and value-add clinical services that enable Providers, Payers and Patients to THRIVE in the new world of value-based care.  We are a fast growth, early stage, small company solving today’s most complex problems with a talented team of disruptors, inventors and change agents who are not satisfied with the status quo and crave to make a difference. We are a ‘Powered Health’ portfolio company supported by a network of resources, experience and industry connections.

 

The Problem: The shift to value-based care is challenging. Providers like the infrastructure, expertise, technology, services, payer-alignment and patient-engagement to effectively improve the cost and quality of care.

 

Our Solution: Vatica Health pioneered the delivery of the industry’s first Provider-centric, Risk Adjustment and Quality (PRAQTM) solution that measures and improves care quality and performance to accelerate the transition to value-based care. We provide innovative technology and services that measurably improve care quality and outcomes, payer and provider financial performance and overall population health.

 

Working at Vatica Health – Do You Have What It Takes?

 

We are seeking smart, hands-on, driven, collaborative team players with a thirst for learning and quest for new experiences to join us on our amazing ‘rocket ride’. You have an entrepreneurial spirit that burns inside and a passion for producing amazing work that measurably impacts our industry.  You crave the opportunity to work shoulder-to-shoulder with industry experts to support your continual learning and customize your own career track.  Our work environment is virtual – “in the cloud” – no cubes, walls or doors. We leverage state-of-the-art technology to communicate, collaborate and get work done - fast.  We focus on results, not inputs. We are flexible, fun and focused. If this sounds like an environment that you would thrive in – we want to talk to you!

 

Role Description

 

As R.N. Coding Specialist /  Nurse Auditor, you will be part of our Risk Adjustment coding department and routinely review cases, eventually managing a team of coders. You will also help in making coding policy decisions for Vatica Health.  This position will be based in our Atlanta, Georgia office and will work both in the office and remotely.

 

Your Responsibilities

  • Independently audit clinical documentation to ensure accuracy
  • Routinely review cases ensuring accurate ICD-10 risk-adjusted coding and clinical documentation. Opportunity to manage a team of risk-adjustment certified coders
  • Assist in making coding policy decisions for Vatica
    • Experience working as a Registered Nurse
    • Risk adjustment coding experience (3 years) and/or the AAPC CRC certification.
    • Working knowledge of ICD-10 guidelines and appropriate clinical documentation.
    • Experience reviewing clinical cases
    • Experience with developing coding policies and helping to make coding policy decisions
      • Current R.N. license  
      • Bachelor’s Degree or equivalent combination of education and experience
      • AACCA certified
      • Must currently have AAPC CRC certification or be willing to complete the course and become certified within the first 3 months of employment.  Vatica will cover the cost of the certification.
        • Greater Atlanta, GA
  • Continually keep abreast of technology changes, regulatory issues, and medical practice through ongoing training and self-directed research and share with others, accordingly
  • Share ideas that offer process improvements and train others team members, accordingly
  • Maintain AAPC CRC Certification.

 

 

Required Experience

Education Requirements

Location

 

Agency Statement

No agencies please.

 

 

Please email resume with cover letter to bmeacham@growthwright.com.

 

 

Vatica Health is an Equal Opportunity Employer.

There are more and more opportunities out there for Certified RN-Coders and Certified RN-Auditors.  Even without ICD10 implementation last year, we have noticed an increase in companies wanting to advertise on AACCA and RN-Coder websites.  Be sure to check this page often for updates!

Licensed RN - Health Risk Educator Consultant

28813BR


This is an in office position in New York City.  There is 50-75% of travel to medical practices within metro New York, and occasionally boroughs and some rural areas.

An RN license is required. Experience with clinical claim review and coding is required.


POSITION SUMMARY
Works with internal business partner (specifically the CRMO clinical coding team), to develop relationships with local network and health care management teams to educate, train, and provide face to face support to physician practice groups who serve our commercial exchange membership (both on and off exchanges, individual and small group clients) in support of risk adjustment.

Uses clinical skills to assess, plan, monitor, and evaluate healthcare services in the provider office setting
participating in direct patient care and assessment.
Responsible for educating providers on how to properly document medical services and interventions received during
face to face member encounters, including proper coding and claim submission for services rendered.
Works on-site in physician offices to assist with scheduling appointments for health risk assessments and other
related medical services in support of our commercial exchange members who may have a gap in care.
Serves as a liaison to peers to provide in-depth clinical knowledge and expertise to support the education of providers.
Performs audits of medical records to ensure all assigned ICD-9 codes are accurate and supported by written clinical
documentation.
Identifies barriers utilizing critical thinking skills to identify improvement opportunities, communicate them to the
national team, and help facilitate gains in efficiency and appropriate risk score capture.
Leads work groups to develop learning strategies to improve health care delivery performance.
Serves as the training resource and subject matter expert to regionally aligned network practices.
Identifies and recommends opportunities for process improvements at the practice level to improve overall risk
adjustment scores and gaps.
Identifies opportunities to promote quality.
Shares best practices in risk adjustment across all sites/regions.
Simultaneously manages multiple, complex projects.

BACKGROUND/EXPERIENCE
-RN with current unrestricted state licensure required.
-CPC certification or CRC certification required. Nurses that currently hold the CPC certification will be required to obtain the CRC certification within 6 months post hire. Nurses that currently hold no coding certification will be required to obtain the CRC certification within 6 months post hire.
-3-5 years clinical experience required.

EDUCATION
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.

LICENSES AND CERTIFICATIONS
Nursing/Registered Nurse (RN) is required

ADDITIONAL JOB INFORMATION
You want to work where you can learn, grow and test yourself. And, of course, you want decent, competitive pay and benefits. You've come to the right place. Our salaries and benefits are market-competitive, with bonuses for high achievers. And our benefits come with lots of choices. All are aimed at helping you achieve health and financial well-being. Our employees health and financial well-being are important to us. As of April 2015, we increased our U.S. minimum base wage to $16 per hour, for both hourly and salaried employees. And effective in 2016, eligible Aetna employees can qualify for an enhanced medical benefits program that could save some families thousands of dollars.

Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.

We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.

Together we will empower people to live healthier lives.

Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.

We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.

We conduct pre-employment drug and background testing. Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Licensed LPN - Health Risk Educator Associate

28812BR

 

This is an in office position in New York City.  There is 50-75% of travel to medical practices within metro New York, and occasionally boroughs and some rural areas.

An LPN or LVN license is required. Experience with clinical claim review and coding is required.

POSITION SUMMARY

Works with internal business partner (specifically the CRMO clinical coding team), to develop relationships with local network and health care management teams to educate, train, and provide face to face support to physician practice groups who serve our commercial exchange membership (both on and off exchanges, individual and small group clients) in support of risk adjustment.

Responsible for educating providers on how to properly document medical services and interventions received during face to face member encounters, including proper coding and claim submission for services rendered.
Works on-site in physician offices to assist with scheduling appointments for health risk assessments and other related medical services in support of our commercial exchange members who may have a gap in care.
Uses clinical skills to coordinate, document, and communicate medical services.
Conducts assigned retrospective chart reviews and reviews health assessment forms for supportive documentation of ICD-9 codes.
Serves as the training resource and subject matter expert to regionally aligned network practices.
Collects information and coordinates documentation for process improvements at the practice level to improve overall risk adjustment scores and gaps.
Shares best practices in risk adjustment across all sites/regions.
Participates in workgroups to develop learning strategies to improve healthcare delivery performance.
Simultaneously participates in multiple, projects.

BACKGROUND/EXPERIENCE
-LPN/LVN with current unrestricted state licensure required.CPC certification or CRC certification required.Nurses that currently hold the CPC certification will be required to obtain the CRC certification within 6 months post hire.Nurses that currently hold no coding certification will be required to obtain the CRC certification within 6 months post hire.
-2+ years of clinical experience required.
-Experience with ICD-9 codes is required
-Clinical Claim Review and Coding experience is required.

EDUCATION
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.

LICENSES AND CERTIFICATIONS
Nursing/Licensed Practical Nurse (LPN) is required

ADDITIONAL JOB INFORMATION
We offer an array of benefits to give you a choice. They are designed to help you achieve health and financial well-being. From competitive benefits to a positive work environment, we strive to help our employees succeed in and out of the office. We've received many employer awards, including: FORTUNE Magazine's most admired company in the Health Care: Insurance and Managed Care category (2009) One of Black Enterprise Magazine's 40 Best Companies for Diversity (2006-2009) Among the Top Companies for Executive Women (2009) Among DiversityInc's Top 50 Companies for Diversity (2009) Ranked first among national health plans in the PayerView rankings (2008) Ranked 23rd among the 100 Best Corporate Citizens (2008)

Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.

We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.

Together we will empower people to live healthier lives.

Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.

We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.

We conduct pre-employment drug and background testing. Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Amerigroup

 

 

Your Talent. Our Vision. At Amerigroup, a proud member of the Anthem, Inc. family of companies focused on serving Medicaid, Medicare and uninsured individuals, it’s a powerful combination.  It’s the foundation upon which we’re creating greater care for our members, greater value for our customers and greater health for our communities. Join us and together we will drive the future of health care.

 

This is an exceptional opportunity to do innovative work that means more to you and those we serve. 

 

 

Clinical Practice Consultant

Locations: Seatlle, WA, Dallas, TX, Houston, TX

 

This work at home position requires approximately 75% local  travel to provider offices in assigned (mileage reimbursed).

A day in the life: can you see yourself building relationships with our network physicians?   If the answer is yes then this could be the next step in your healthcare career!

 

  • Educate providers and office staff on HEDIS requirements and clinical documentation/coding as part of office visits and develop working relationships to facilitate care gap closures.
  • During HEDIS season conduct provider medical record reviews and abstract information as part of the data collection process in addition to providing support for over read process related to auditor requirements.
  • Works with QM (Quality Management) and plan leaders to identify opportunities for collaboration with provider offices and facilitates development and follow up of action plans or deliverables.
  • Perform coding audits/analysis on providers.

Holiday Pay is immediate upon employment upcoming dates include: November 27 & 28, December 25 and January 1 & 19.

 

Job Qualifications

Requirements include:

  • AS/BS in nursing with current unrestricted WA RN or LPN license, BSN/MSN preferred
  • CCS/CPC/RHIT/RHIA strongly preferred
  • 2 years of clinical experience
  • 2 years experience coding or performing coding audits preferred
  • 5 years of managed care experience (includes related experience)
  • 2 years of professional presentations to small and large audiences or any combination of education and experience, which would provide an equivalent background.
  • 2 years HEDIS experience
  • Intermediate skills in Microsoft Word, Excel and PowerPoint required

http://careers.antheminc.com/job/5824024/practice-consultant-coder-109264-seattle-wa/

http://careers.antheminc.com/job/5850217/practice-consultant-coder-109508-dallas-tx/

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2014 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran

 

CLINICAL AUDITOR


Building healthy futures…
…for our patients and our team.



Southeast Georgia Health System has served the residents of and visitors to the beautiful Golden Isles and surrounding areas of Southeast Georgia since 1888. Just as we strive to treat our patients with leading-edge technology, services and procedures, we do our utmost to keep our team members fulfilled by investing in their development, rewarding strong performance and making SGHS a great place to work.

Southeast Georgia Health System offers an excellent compensation package, including comprehensive benefits. We are currently seeking the following professional to join our Compliance Team!

Clinical Auditor


The nurse auditor conducts clinical audits to determine if documentation meets medical necessity and regulatory guidelines. Works closely with the Health System Compliance Officer, Medical Records and Patient Financial Services to prepare audit results and potentially self-report any overpayments to various government and other 3rd party payers. Tracks refunds and, if required, helps develop an ongoing Auditing & Monitoring Action Plan for the operational departments under review to ensure continued compliance with all regulations. Reviews and distributes regulatory guidance such as the annual HHS-Office of Inspector General Audit Plan to appropriate operational departments and entities, such as the Senior Care Centers, for further review.

Develops the Health System's annual Audit Plan, based upon review of annual HHS-OIG and CMS Audit Work Plans, periodic CMS Fraud Alerts, other government program initiatives. Conducts regulatory research on Medicare, Medicaid, Tricare, and other government agency regulations; performs audits or oversees departments auditing certain program areas. Prepares all related written report.

Assists the Compliance Officer, as needed, in resolving multi-faceted compliance issues received through the Alertline, Quantros, etc., that may involve the Health Insurance Portability & Accountability Act (HIPAA), the Emergency Medical Treatment & Active Labor Act (EMTALA), and other regulatory areas where there may be program deficiencies.

Performs other related duties as required.


Qualifications:

  • Graduate of an accredited nursing program or bachelor's degree in a health-related field required.
  • 5 years in nursing or healthcare-related experience.
  • Applicable current Georgia licensure and/or certification in clinical /technical field required.
  • Valid Georgia driver's license required.
  • Good organizational, planning, time management, verbal/written communication and interpersonal skills.
  • Ability to apply knowledge of medical terminology, abbreviations, anatomy and physiology, major disease processes and/or pharmacology to investigate and respond to documentation issues.

For additional information and to apply online, visit:

 

www.sghs.org

 

Or you may apply to the direct link below:

 

http://jobs.sghs.org/jobs/1221292-Clinical-Auditor-FT-.aspx



All qualified applicants will receive consideration for employment without regard to race, color, religion, sex or national origin. EOE/AA M/F/D/V

  • Hires only Non-Tobacco Users

 =====================================================================================

Job Title: Patient Accounts Nurse Auditor - RN

Department: Patient Business Services

Job Number: 34571

Location: Memphis, TN

 

St. Jude Children’s Research Hospital is a world-renowned institution that is recognized as one of the best places to work in the nation. As a premier center for research and treatment of childhood catastrophic diseases, we employ a diverse team of scientific and healthcare professionals dedicated to the promise of hope. Children from all 50 states and from around the world have come through the doors of St. Jude for treatment, and thousands more have benefited from our research.

 

The Patient Accounts Nurse Auditor, under the supervision of the Patient Accounts Manager, concurrently reviews medical records to determine appropriate documentation and substantiates the medical necessity and coding of insurance claims. (KF)

 

WORK SCHEDULE:

Monday – Friday; 8:00 AM - 4:30 PM  

 

Job Qualifications:

EDUCATION REQUIREMENTS: 
Graduation from a school of nursing required.
 
EXPERIENCE REQUIREMENTS:
Two (2) years in a hospital business office setting performing healthcare claim audit functions and responsibilities required.
Experience using and familiarity with medical and billing claim forms preferred.
 
LICENSURE REQUIREMENTS:
Must possess a current Tennessee State Board of Nursing license if primary residence is Tennessee or a Nurse Licensure non-Compact state.
Must possess a current State Board of Nursing license in the state of primary residence if the state is a Nurse Licensure Compact state.
 
OTHER CREDENTIAL REQUIREMENTS:
Certification with the American Association of Clinical Coders and Auditors preferred.

 

 

To apply online, visit: https://jobs.stjude.org/css_external/CSSPage_Referred.ASP?Req=34571&s_cid=3-1-1853-36-25632

 

St. Jude Children’s Research Hospital is an Equal Opportunity Employer. St. Jude does not discriminate on the basis of race, national origin, sex, genetic information, age, religion, disability, sexual orientation, gender identity, transgender status, veteran’s status or disabled veteran’s status with respect to employment opportunities.  All qualified applicants will be considered for employment.  St. Jude engages in affirmative action to increase employment opportunities for minorities, women, veterans and individuals with disabilities.


Risk Adjustment Revenue Nurse (RN or LPN)

This position is a work at home position for candidates that reside in New York and does require 50%-75% local travel. Qualified candidates will hold their RN or LPN license and have at least 3 years of medical record review, diagnosis coding or auditing experience.

 

POSITION SUMMARY

Work with internal business partners specifically with the CRMO clinical coding team - to develop relationships with local network and health care management teams to educate, train, and provide face to face support to physician practice groups who serve our commercial exchange membership (on and off exchange IVL and SG) in support of risk adjustment. RN or LPN with current unrestricted state licensure required.

 

Fundamental Components:

- Traveling on-site to physician offices to assist with scheduling appointments for health risk assessments and other related medical services in support of our commercial exchange members who may have a gap in care.

- Focus of role is to educate providers on how to properly document medical services and interventions received during face to face member encounters.

- This documentation includes proper coding and claim submission for services rendered.

- Will perform audits of medical records to ensure all assigned ICD-9 codes are accurate and supported by written clinical documentation.

- Serves as the training resource and subject matter expert to regionally aligned network practices.

- Identifies and recommends opportunities for process improvements at the practice level to improve overall risk adjustment scores and gaps.

- Shares best practices in risk adjustment across all sites/regions.

- Participates in workgroups to develop learning strategies to improve healthcare delivery performance

- Simultaneously manage multiple, complex projects

 

BACKGROUND/EXPERIENCE

- Knowledge of regulatory/accreditory guidelines, quality of care and member safety issues

- Min 4 yrs recent experience in medical record review, diagnosis coding, and/or auditing is required.

- CPC (Certified Professional Coder) or CCS-P (Certified ICD-9 Coding Specialist-Physician) is preferred

- Exp with Medicare and/or Commercial risk adjustment process

- Exp/understanding of elect med & health records

 

EDUCATION

The minimum level of education desired for candidates in this position is a Associate's degree or equivalent experience.

 

ADDITIONAL JOB INFORMATION

This position will require regional travel to Aetna's provider offices, clinics, and facilities.

Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding.

 

Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come. We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence. Together we will empower people to live healthier lives.

 

Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities. We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.

 

We conduct pre-employment drug and background testing. Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

 

Please apply at https://sjobs.brassring.com/TGWebHost/home.aspx?partnerid=25276&siteid=5012 and use Req # 24968BR

 

Manager of Risk Adjustment (RN or LPN)

This is a work at home position for candidates residing in Southern, CA. Candidates must be comfortable traveling between 25%-50% of the time. Ideally looking for candidates that have 2+ years of supervisory experience as well as a background in coding or medical record review. 

Key Components of the Clinical Risk Manager Position 
• Manager will oversee staff nurses assigned to specific providers who will have direct access and interaction with the physician and office staff. The manager staff monitors access to relevant data; interact with health plan staff and supportive resources. 
• Collaborates with field, internal and provider staff to facilitate member access to care/assessment, adherence to best practices, and coordination of services. 
• Supports relevant member specific risk data for each assigned provider location and ensures targeted identified gaps in care are addressed in a timely and coordinated manner. 
• works collaboratively with the Risk Adjustment, Quality and Network Mgmt. Team to educate and provide feedback to targeted providers. 
• QCC is also a resource for correct risk adjustment diagnostic and procedural coding that meets required standards. In addition, the staff will ensure appropriate, timely submission of related risk adjustment data to the organization. In support of the program to monitor encounter data submission to the organization, QCC staff serves as a liaison and resource for the encounter data analysis analyst. The manager may be a resource to the member and provider by providing the appropriate information to facilitate resolution of issues that arise and to positively impact plan perception and member and provider satisfaction. 

A. Key Job Responsibilities 
i. Monitors provider group assigned involving multiple locations. The following Southern California counties represent the majority of high priority providers: Riverside, San Bernardino, Los Angeles, San Diego & Orange counties. 
ii. Ongoing training and orientation. 
iii. Manager may gradually add other locations depending on the number of members. In order to maximize effectiveness, the maximum number of members/care coordinator should not exceed 2500. 
B. Interfaces with key departments for reporting, technical support, data gathering processes and collection 
C. Discuss and provides advice regarding Risk Reports for assigned Medical Groups and selected physicians and members. 

BACKGROUND/EXPERIENCE 
2+ years of experience in coding or medical record review is required. 
2+ years of managerial or supervisory experience is highly preferred 
Experience in risk management or risk adjustment is preferred 
Experience in a field based role is helpful 
Registered Nurse (RN) or Licensed Practical Nurse (LPN) is required. 

EDUCATION 
The minimum level of education desired for candidates in this position is a GED or High School Diploma. 

Telework Specifications: 
Full-Time Telework (WAH) 

ADDITIONAL JOB INFORMATION 
Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come. We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence. Together we will empower people to live healthier lives. 

Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities. We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard. 

We conduct pre-employment drug and background testing. Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Please apply at https://sjobs.brassring.com/TGWebHost/home.aspx?partnerid=25276&siteid=5012 and use                   Req # 25415BR

 ------------

Risk Adjustment Nurse (RN or LPN)

This is a fulltime work at home position and does require up to 25% local travel. Candidates can reside in Southern California or in Washington. Qualified candidates will hold their RN or LPN license and have a minimum of 1 year of medical record review, diagnosis coding or auditing experience. 

POSITION SUMMARY 
Work with internal business partners specifically with the CRMO clinical coding team - to develop relationships with local network and health care management teams to educate, train, and provide face to face support to physician practice groups who serve our commercial exchange membership (on and off exchange IVL and SG) in support of risk adjustment. RN or LPN with current unrestricted state licensure required. 

Fundamental Components: 
- Traveling on-site to physician offices to assist with scheduling appointments for health risk assessments and other related medical services in support of our commercial exchange members who may have a gap in care. 
- Focus of role is to educate providers on how to properly document medical services and interventions received during face to face member encounters. 
- This documentation includes proper coding and claim submission for services rendered. 
- Will perform audits of medical records to ensure all assigned ICD-9 codes are accurate and supported by written clinical documentation. 
- Serves as the training resource and subject matter expert to regionally aligned network practices. 
- Identifies and recommends opportunities for process improvements at the practice level to improve overall risk adjustment scores and gaps. 
- Shares best practices in risk adjustment across all sites/regions. 
- Participates in workgroups to develop learning strategies to improve healthcare delivery performance 
- Simultaneously manage multiple, complex projects 

BACKGROUND/EXPERIENCE 
Knowledge of regulatory/accreditory guidelines, quality of care and member safety issues 
Min 1 year recent experience in medical record review, diagnosis coding, and/or auditing is required. 
CPC (Certified Professional Coder) or CCS-P (Certified ICD-9 Coding Specialist-Physician)is preferred 
Exp with Medicare and/or Commercial risk adjustment process 
Exp/understanding of electronic medical & health records 

EDUCATION 
The minimum level of education desired for candidates in this position is a Associate's degree or equivalent experience. 

ADDITIONAL JOB INFORMATION 
This position will require regional travel to Aetna's provider offices, clinics, and facilities. Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding. 

Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come. We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence. Together we will empower people to live healthier lives. 

Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities. We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard. 

We conduct pre-employment drug and background testing. Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Please apply at https://sjobs.brassring.com/TGWebHost/home.aspx?partnerid=25276&siteid=5012 and use                   Req # 25270BR