Risk Adjustment Coder

The Coder, Risk Adjustment position provides a thorough concurrent, prospective, and retrospective review of ambulatory medical record clinical documentation to ensure accurate and complete capture of the clinical picture, severity of illness, and complexity of the patient. The Risk Adjustment Coder is responsible for evaluating the accuracy and consistency of coded clinical data quality results and reports following all applicable federal, state, and county regulations/laws related to coding, auditing, and clinical documentation guidelines for the various risk adjustment models. May participate in developing, presenting, and disseminating provider communication and other activities related to clinical documentation.

Responsibilities

Provide thorough concurrent, prospective, and retrospective review of ambulatory medical record clinical documentation to ensure accurate and complete capture of the clinical picture, severity of illness, and complexity of the patient; Evaluate the accuracy and consistency of coded clinical data quality results and reports following all applicable federal, state, and county regulations/laws related to coding, auditing, and clinical documentation guidelines for the various risk adjustment models; May participate in developing, presenting, and disseminating provider communication and other activities related to clinical documentation

Requirements

High School Diploma required; A minimum of 2 years of risk adjustment coding and/or auditing experience is required; Electronic health record (EHR)/medical records (EMR) experience with the ability to navigate a variety of EHRs/EMRs; Candidates must have one of the following certifications: Certified Risk Adjustment Coder (CRC), Certified Professional Coder (CPC), or Certified Coding Specialist (CCS, CCS-P)

Nice to have

Prior experience with Medicare Managed Care (Medicare Advantage)

Benefits

Medical, Dental and Vision insurance; 403(b) Retirement savings plans with employer matching contributions; Flexible Spending Accounts; Commuter Flexible Spending; Career Advancement & Development opportunities; Paid Time Off & Holidays; Paid CME Days; Malpractice insurance and tail coverage; Tuition Reimbursement Program; Corporate Employee Discounts; Employee Referral Bonus Program; Pet Care Insurance