Coder WellSense Health Plan is a nonprofit health insurance company serving members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded 25 years ago as Boston Medical Center HealthNet Plan, we provide plans and services that work for our members, no matter their circumstances. Apply now (https://jobs.silkroad.com/BMCHP/Careers/Apply/MultiForm/294431) It’s an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances. **Job Summary:** The Coder manages the day-to-day responsibilities of chart abstraction, vendor auditing and reporting in accordance with state and federal regulations. The coder will abstract from in-patient and out-patient medical records and record findings via electronic database and or excel spread sheets. The coder ensures that all claims accurately reflect the appropriate diagnosis information as outlined in the member’s medial record. Our Investment in You: · Full-time remote work · Competitive salaries · Excellent benefits **Responsibilities** · Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10-CM codes are accurately assigned and supported by clinical documentation. · Ability to code government and state models. This includes code everything projects. · Maintain current knowledge of ICD-10-CM codes, CMS documentation requirements, and state and federal regulations. · Ability to maintain a 95% accuracy rate on all coding projects. · Coders assist with code abstraction and coding quality audits using the Official Coding Guidelines for ICD-9-CM/ICD-10-CM, AHA Coding Clinic Guidance, and in accordance with all state regulations, federal regulations, internal policies, and procedures. **Requirements** · Current core coding credentials through AHIMA or AAPC (RHIT, CCS, CCS-P, CPC, CIC, etc.) The AAPC CRC (Certified Risk Adjustment Coder) coding certification is highly recommended. · Strong organizational skills · Technical savvy with high level of competence in basic computer skills, Microsoft Outlook, Word, Excel and Outlook. · Strong written and verbal communication skills · Ability to work independently in a remote environment · Private lockable office space to ensure security of Member PHI · Minimum of 5 years coding experience with at least 3 of those years in Risk Adjustment coding. · Completion of an accredited medical coding program with current unencumbered credentials. **Required education:** · CPC Certification **Required experience** : · Risk Adjustment coding: 3 years · Coding: 5 years **Supervision Received** · General supervision is received weekly **About WellSense** WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances. WellSense is committed to the diversity and inclusion of staff and their members. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status. WellSense participates in the E-Verify program to electronically verify the employment eligibility of newly hired employees Apply now (https://jobs.silkroad.com/BMCHP/Careers/Apply/MultiForm/294431) **_Important info on employment offer scams:_** _According to the FTC, there has been a rise in employment offer scams. Our current job openings are listed on our website and applications are received only through our website. We do not reach out to individuals via text, we do not ask or require downloads of any applications, or “apps”, and applicant screenings, interviews and job offers are not conducted over text messages or social media platforms. We do not ask individuals to purchase equipment for, or prior to employment. To avoid becoming a victim of an employment offer scam, please followthese tips from the FTC (https://consumer.ftc.gov/consumer-alerts/2023/01/looking-job-scammers-might-be-looking-you?utm\_source=govdelivery) ._