JOB DESCRIPTION

Provides senior level support for coding activities. Responsible for monitoring adherence to Molina's compliance program, minimizing risks related to coding and billing practices, and protecting the business from liability related to fraudulent/abusive practices. Performs chart reviews, facilitates physician education, and maintains comprehensive knowledge of coding rules and regulations.

Essential Job Duties

• Provides senior level coding expertise and administrative technical oversight to ensure successful integration of departmental initiatives.
• Performs ongoing chart reviews and abstracts diagnoses codes in alignment with the Hierarchical Condition Categories (HCC) model.
• Leverages understanding of current billing practices in provider offices to ensure that diagnoses codes are submitted appropriately.
• Documents results/findings from chart reviews, and provides feedback to leadership, providers, and office staff.
• Cr...