About WellCare: WellCare Health Plans, Inc. provides managed care services targeted to government-sponsored health care programs, focusing on Medicaid and Medicare. Headquartered in Tampa, Fla., WellCare offers a variety of health plans for families, children, and the aged, blind and disabled, as well as prescription drug plans. The company serves approximately 3.3 million members nationwide as of January 1, 2014. The company employs more than 5,100 nationwide. For more information about WellCare, please visit the company's website at www.wellcare.com. A Fortune 500 company traded on the New York Stock Exchange (symbol: WCG).
EOE: All qualified applicants shall receive consideration for employment without regard to race, color, religion, sex, age forty (40) and over, disability, veteran status, or national origin.
Codes, abstracts and analyzes inpatient and/or outpatient medical records using International Classification of Diseases, Ninth Revision (ICD-9) for CMS risk adjustment purposes.
- Codes, abstracts and analyzes inpatient and/or outpatient medical records using International Classification of Diseases, Ninth Revision (ICD-9). Always coding to the highest level of specificity.
- Follows the Official ICD-9 guidelines for Coding and Reporting and has a complete understanding of these guidelines.
- Follows CMS risk adjustment guidelines and has a complete understanding of these guidelines.
- Understands the impact of ICD-9 codes on the CMS HCC risk adjustment model.
- Ability to meet productivity and accuracy standards
- Ability to defend coding decisions to both internal and external audits.
- Other projects as necessary.
Education: High School Diploma, Associate's Degree preferred or equivalent work experience
- 2-4 years professional coding experience either in a hospital or physician setting
- Expert knowledge of medical terminology and abbreviations and disease, illness and injury processes
- Managed Care experience preferred
- Working knowledge of CMS risk adjustment model preferred
Licenses/Certifications: CPC or CCS required
Special Skills (e.g. 2nd language):
- Must be able to effectively communicate verbally and in writing complex coding issues
- Must be able to understand and follow verbal instructions and written policies and procedures to ensure adherence to standards and to instructions from management.
- Must be able to read, write, speak, and understand English in order to communicate with customers, staff, vendors, and management.
- Ability to work individually or as part of a team