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Risk Adjustment Coding Specialist - Remote
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Job Description
- Req#: 00636650
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Competitive compensation and benefits packages including medical, dental, and vision with coverage starting on day one.
- Retirement savings account with employer match starting on day one.
- Generous paid time off programs.
- Tuition/professional development reimbursement starting on day one, including 100% paid RN to BSN tuition at Mount Carmel's College of Nursing.
- Opportunity to join Diversity, Equity, and Inclusion Colleague Resource Groups.
- DailyPay option available for eligible colleagues, allowing access to earned wages before payday.
What to Expect (Job Responsibilities):
- Review and evaluate patient medical records to determine the level of Evaluation and Management (E/M) service and accurately assign CPT, modifiers, and ICD-10 codes.
- Collaborate with providers to clarify documentation and educate on risk adjustment coding best practices.
- Conduct retrospective and prospective coding reviews to identify missed or undocumented Hierarchical Condition Categories (HCCs).
- Maintain compliance with CMS, HHS, and payer-specific risk adjustment guidelines.
- Train and mentor peers and new coders on risk adjustment coding standards and documentation requirements.
What is Required (Qualifications):
- High School Diploma or Equivalent required.
- Certified Risk Adjustment Coder certification within one year of hire required.
- Minimum of two years of experience in medical coding and billing required.
- Understanding of various medical claims formats and working knowledge in medical terminology, CPT, and ICD-10 coding.
- Expanded knowledge of Risk Adjustment and HCC coding.
How to Stand Out (Preferred Qualifications):
- Active and up-to-date CPC certification preferred.
- Knowledge of payer contracts and reimbursement.
#HealthcareServices #MedicalCoding #RiskAdjustment #CareerOpportunity #CompetitivePay
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