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From Home Optum Health Coding Risk Adjustment Jobs in Louisiana

Arbor Family Health

Coding/Billing Clerk

New Roads, LA · On-site

As a Coding/Billing Clerk, you will abstract clinical information from medical records and assign ... Assign Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), and ...

New

The Jernigan Agency

WORK FROM HOME

Baton Rouge, LA · On-site +1

We are hiring coachable individuals comfortable with a 100% commission based income selling Life and Health Insurance. As this is a commission based income, there is no cap on your earnings. We use ...

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All JobsOptum Health Coding Risk Adjustment JobsFrom Home Optum Health Coding Risk Adjustment JobsFrom Home Optum Health Coding Risk Adjustment Jobs in Louisiana

From Home Optum Health Coding Risk Adjustment information

What is the difference between From Home Optum Health Coding Risk Adjustment vs From Home Optum Health Medical Coding?

AspectFrom Home Optum Health Coding Risk AdjustmentFrom Home Optum Health Medical Coding
CertificationsCCS, CPC, or RHIT/RHIACCS, CPC, or RHIT/RHIA
Work EnvironmentRemote, home-basedRemote, home-based
Industry UsageHealth insurance, risk adjustment programsHealthcare providers, hospital coding
Job FocusRisk adjustment coding for insurance accuracyClinical coding for medical records

While both roles involve medical coding from home, From Home Optum Health Coding Risk Adjustment focuses on coding for insurance risk adjustment programs, requiring specific risk adjustment knowledge. In contrast, From Home Optum Health Medical Coding emphasizes clinical coding for medical records, often in hospital or provider settings. Both roles require similar certifications and offer remote work, but their primary focus and industry applications differ.

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From Home Optum Health Coding Risk Adjustment jobs near you

Coding/Billing Clerk

Arbor Family Health

New Roads, LA • On-site

Full-time

Medical, Dental, Vision, Life, PTO

Posted 2 days ago

New

Job description

JOB DESCRIPTION

As a Coding/Billing Clerk, you will abstract clinical information from medical records and assign accurate ICD-10-CM, CPT, and HCPCS codes using industry-standard guidelines. You will also support billing and claims workflows by ensuring documentation is complete, charges are entered correctly, codes are sequenced according to regulatory and payer requirements, and claim issues are followed through to resolution. You will work within coding and billing databases, perform quality audits, and maintain up-to-date knowledge of coding and documentation requirements. This role reports to the Medical Records Coding Supervisor.

Job SpecificationsDuties & Responsibilities (Department-Specific)

  • Assign Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), and ICD-10-CM (ICD-10 Clinical Modification) codes based on documentation.

  • Assign Ambulatory Payment Classifications (APC) and/or Diagnosis-Related Group (DRG) codes as required.

  • Select appropriate codes and functions for each case, including diagnoses, procedures, and complex classification scenarios.

  • Abstract and code patient encounters accurately.

  • Research and analyze coding and documentation needs to support reimbursement.

  • Ensure codes are sequenced correctly according to government and insurance regulations.

  • Verify that medical records are filed and processed correctly.

  • Analyze medical records to identify documentation deficiencies and coding opportunities.

  • Serve as a resource and subject matter expert to other coding staff.

  • Review and verify documentation for diagnoses, procedures, and treatment outcomes.

  • Identify diagnostic and procedural information necessary for coding.

  • Process claims through the charge entry process for medical and dental clinics.

  • Follow up on claim denials and other billing-related issues.

  • Complete billing clean-up tasks, including working denials, verifying guarantor information, and following up on missing information as directed by the Reimbursement Coordinator.

  • Maintain tracking logs for all claims worked for clean-up and follow-up actions.

  • Review daily superbills to confirm charge posting, coding accuracy, primary diagnosis selection, and completeness of insurance and patient documentation.

  • Record diagnoses on required forms used to complete clinic insurance documentation.

  • Follow up on secondary payments on Medicare claims.

General Performance Standards

  • Use clinic resources efficiently and effectively.

  • Maintain discipline and follow accepted office standards.

  • Work with minimal supervision by seeking guidance when issues arise beyond current knowledge or experience.

  • Attend clinic and staff meetings, participate actively in problem-solving, and support in-service training.

  • Communicate clearly and professionally with patients, visitors, and team members, while adhering to customer service standards.

  • Maintain confidentiality of patient information and clinic business, and support the clinic mission and patient rights and responsibilities.

  • Perform duties in accordance with all clinic policies and procedures.

  • Participate in education opportunities that improve coding and billing effectiveness.

  • Remain flexible to support cross-training and adjustments to the work schedule as needed, in alignment with clinic policy.

  • Stay current with and follow all policies and procedures in the Policy & Procedure Manual.


REQUIREMENTS

    ABOUT THE COMPANY

    Arbor Family Health is a Federally Qualified Health Center (FQHC) serving Pointe Coupee, West Baton Rouge and Iberville Parishes.

    Benefits Include:

    • Competitive salary

    • Health, vision, dental and life insurance

    • Paid holidays and Paid Time Off

    • Continuing education support