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QC Medical Coder II

Advance Possibility
Join Episource, a leading provider of risk-adjustment services, software, and solutions for health plans and medical groups.

You are a highly organized and efficient individual who can manage multiple tasks and projects simultaneously effectively — join our flourishing team as Episource’s QC Medical Coder II.

This role has a moderately flexible 40-hour workweek and reports to Episource’s Manager, Coding Quality.

What will you do as Episource’s QC Medical Coder II
As our QC Medical Coder II, you will review medical records coded by peers to ensure the accuracy, completeness, specificity, and appropriateness of diagnosis codes. You will verify that the codes are based on documentation that meets established CMS and client-specific MRA and ACA coding guidelines.

Here’s how you’ll impact Episource:

Serve as a coding compliance SME. As Episource’s QC Medical Coder II, you’ll fully understand coding compliance and reimbursement procedures for the top Medicare Risk Adjustment HCCs.
Flaunt your meticulous eye for detail. You’ll be responsible for peer-to-peer and vendor over-reads using an organized and detail-oriented approach.
Act as a communication liaison. You’ll prepare and present written feedback to both coding staff and upper management.

What your journey at Episource will look like:

In your first thirty days at Episource, you will learn about our system and Salesforce. You’ll begin communicating with coders throughout this time.
Throughout the first sixty days at Episource, you’ll know the guidelines and will have developed a relationship with the coders.
By the end of your first ninety days at Episource, you’ll experience spearheading several projects simultaneously.

What you will bring to the Expert Teams at Episource:

5+ years in Medicare risk adjustment space with a focus on peer-to-peer reviews
Associate’s degree required (or equivalent combination of education and experience)
Superior communication skills
Excellent computer proficiency: specifically in Microsoft Office
Extensive knowledge of diagnostic coding and HCC documentation requirements
Current working knowledge of ICD-10-CM, CPT, HCPCS coding

EPIC Core Values: Entrepreneurial, P*ositive, Integrity, C*ustomer-focused
The embodiment of our EPIC Core Values defines our team member experience. We are proud to demonstrate and celebrate these values daily, and we showcase these to one another, our candidates and applicants, and our esteemed clients.

Expert Teams. Ingenious Technologies.
Our journey started in 2006 with medical billing and coding services for physicians, then pivoted to HCC coding for payers. We’ve grown by learning and listening to clients. Our entrepreneurial mindset drives innovation and collaboration. Fifteen years later, we are a platform company delivering insights and interventions using superior technology workflows.

Salary Range: $66,000–$70,000/year
Pay is based on several factors, including but not limited to education, work experience, certifications, location, and other relevant factors. This is Episource’s good faith and reasonable estimate of the compensation range for this position as of the time of posting.

Episource will require proof of COVID-19 vaccination for all patient-facing healthcare workers and client-facing employees.

Episource, LLC provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Episource, LLC complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, placement, promotion, termination, layoff, recall, transfer, leave of absence, compensation, and training.

Job Type: Full-time

Pay: $66,000.00 - $70,000.00 per year

Benefits: