- Knowledge of Risk Adjustment and Hierarchical Condition Categories (HCC) and Medicare Advantage reimbursement
- Task-oriented and ability to meet designated deadlines and productivity standards
- Excellent understanding of medical terminology, disease process and anatomy and physiology
- Excellent understanding of ICD-10-CM coding classification
- Excellent understanding of CPT/HCPCS coding
- Medicaid, Medicare and Commercial business products knowledge/experience .
| - Proficiency in Microsoft Word, Excel and SharePoint
- Knowledge of CMS-1500 – Health Insurance Claim Form.
- Knowledge of federal and state guidelines on all coding systems and sponsored programs
- Advanced knowledge of auditing concepts and principles
- Ability to use independent judgment and to manage and impart confidential information
- Strong oral and written communication skills. Excellent organization and problem-solving skills
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