This site uses cookies. To find out more, see our Cookies Policy

Medical Coding Specialist in The Bronx, NY at Pride Health

Date Posted: 5/20/2019

Job Snapshot

  • Employee Type:
  • Location:
    The Bronx, NY
  • Experience:
    Not Specified
  • Date Posted:

Job Description

Medical Coding Specialist

Responsible for providing education to the staff with appropriate coding and the coding guidelines. 

Maintains the accuracy of the diagnostic information contained in the members’ electronic medical record and consistency DOH and departmental diagnostic information.

Educate assessors in proper code assignment and risk point factors.

Job Requirements

Bachelor's degree or equivalent years of experience.

Minimum of two (2) years medical insurance/healthcare Coding.

Must have a current CPC or CCS certification thru AAPC or AHIMA. 

Knowledge in Long Term Care coding and proficiency with Managed Long Term Care (MLTC) CMS coding guidelines. 

Ability to audit and/or abstract code medical records for proper assignment of diagnoses specificity (including HCC/risk adjustment concepts) procedure codes, units, sites, modifiers, drugs, supplies. Knowledge in ICD-9, ICD-10 CM, HCPCS and CPT-4 codes


Reviews, verifies, and maintains the accuracy of all diagnostic information contained in the member’s electronic medical records via Lychee and diagnostic information provided in the UAS-NY.

Ensures coding consistency between internally maintained electronic medical records and DOH reported diagnostic information.

Analyzes medical codes within the Department of Health’s Uniform Assessment System for New York (UAS-NY) to assess a member’s eligibility for the plan’s services.

Efficiently communicates via e-mail with nurses to provide any necessary clarifications and education about coding corrections.

Assesses coding done by nurses to ensure there are no discrepancies and/or incorrect coding between Lychee and UAS-NY.

Conducts audits for missed charges and records information.

Remains current with CPT and ICD-10 guidelines for coding and diagnostic procedures

Performs other duties as assigned.