At Central Maine Healthcare our team members are committed to providing exceptional care and experiences for our community and for each other every day. Central Maine Healthcare is seeking a remote Clinical Coder to join our Accountable Care Organization Team. This is a full time, benefits eligible position. ​Need to be available to attend occasional meetings and trainings. Starting pay is $23.75 per hour. The Clinical Coder will be responsible for reviewing Central Maine ACO providers’ medical record documentation to ensure use of accurate medical coding of all professional, inpatient and outpatient services, procedures, diagnoses and conditions in support of complete and accurate risk adjustment revenue for applicable ACO populations. The coder will review provider documentation of ICD-9-CM/ICD-10-CM codes to verify that coding meets both established coding standards as well as CMS Risk Adjustment guidelines. The coder will lead efforts to evaluate the HCC coding practices and provide analyses and recommendations to improve overall provider documentation and coding. The Risk Adjustment Coding Auditor will review medical records to determine if diagnostic codes (ICD-9-CM/ICD-10-CM) are accurately reflecting the provider documentation. The coder will summarize findings for internal and external parties. Education and Experience: + Bachelor’s Degree or combination of relevant education and experience + Certified Professional Coder (CPC) or Certified Coding Specialist (CCS); Certified Risk Adjustment Coder (CRC) preferred + 2+ years of billing/coding experience in a medical/surgical or facility setting + Knowledge of diagnoses/procedures in accordance with ICD-9/10-CM coding principles for HCC coding + Experience with CMS Medicare Advantage Risk Adjustment preferred + Ability to work with physicians and care team staff in a collaborative manner What It’s Like Working At CMH: We are all about our team members growth and health. That why we prioritize work/life balance, community-based wellness initiatives and tuition reimbursement or student loan repayment for ALL of our team members. CMH offers a robust benefits package that includes: + Robust Paid Time Off (PTO) program + Medical plan with enhanced Tier 1 benefits provided within the CMH system. + Dental plan + Vision plan + Health Savings Account (HSA) + Basic Life insurance at no cost + Supplemental Life insurance + Long-term disability insurance + 401(k) or 403(b) retirement savings plans + Tuition IO partnership for student loan repayment assistance and tuition assistance + Family leave program for Parental Leaves + Comprehensive Wellness Program Essential Duties: + Accurately and efficiently reviews medical charts and assigns the correct diagnosis (ICD-9/10 CM), procedure (CPT), and supply (HCPCS Level II) code for a wide variety of clinical cases and services. + Identify, collect, assess, monitor and document claims and encounter coding information as it pertains to Clinical Condition Categories. + Verify and ensure the accuracy, completeness, specificity and appropriateness of diagnosis codes based on services rendered. + Review medical record information to identify all appropriate coding based on CMS HCC categories. + Effectively communicates with physicians in order to clarify diagnoses/procedures and sequencing of diagnoses. + Utilizes specialized coding knowledge and auditing skills to achieve established coding quantity and quality standards. + Assesses medical coding practices and suggests areas of improvement for follow up physician training and communication. + Performs other duties as assigned. If you are passionate about making a difference and are looking for your next great career opportunity, we look forward to reviewing your application! AT CENTRAL MAINE HEALTHCARE YOU ARE AT THE CENTER OF EVERYTHING WE DO Our why, our purpose, drives every decision and action we take as a healthcare system. We strive everyday to deliver exceptional care, and to improve our community. We are a non-profit organization that is breaking the traditional healthcare mold by bringing our patients and their family’s high value, low cost, and award-winning care while focusing on creating an exceptional experience for them; all within their communities. To accomplish this, we only hire individuals who are committed to excellence, who embody the principles of our CMH Experience Service Standards, and who are ready to step in and help their fellow team members achieve those exceptional results for our patients, their families, and the community. Central Maine Healthcare System The organization is broad in its footprint, with three (3) hospitals in Bridgton, Lewiston, and Rumford, and over 75 individual practices within our Medical Group. Lewiston’s Central Maine Medical Center is a certified and award-winning level two trauma center, along with our Central Maine Heart and Vascular Institute and the upcoming highly anticipated launch of our comprehensive state of the art cancer treatment center. Both Bridgton and Rumford Hospitals are four (4) star accredited acute care hospitals, and our Medical Group and Maine Urgent Care Centers have won multiple awards within their specialties. As a system we are a six-time winner of the Leapfrog Safety A Rating since 2019, representing some of the highest quality care and outcomes nationwide. Our awards and accolades are only possible as a result of our commitment to culture, and a focus on safety and inclusion, in each of our patient’s experiences and in the experiences we create within our teams. If you are a person who is looking for a way to give back to your community, to help improve the lives of patients or those who care for our patients, want to be part of a growing organization that is setting the bar for Maine healthcare, apply to join Central Maine Healthcare today! Diversity and Equal Employment Opportunity CMH actively promotes diversity in its workforce at all levels of the organization. We strive to create and maintain a setting where we celebrate cultural and other differences and consider them strengths of the organization. CMH is an equal opportunity workforce and no one shall discriminate against any individual with regard to race, color, religion, sex, national origin, age, disability, sexual orientation, gender identity, genetic information or veteran status with respect to any offer, or term or condition, of employment. We make reasonable accommodations to the known physical and mental limitations of qualified individuals with disabilities.