Government Programs Risk Adjustment Coder

Responsibilities:

• Perform comprehensive review and oversight of medical records for Risk Adjustment compliance keeping with CMS and departmental guidelines with a 95%+ accuracy rate
• Offer suggestions and assistance for improvement in departmental processes & other duties as assigned
• Maintains responsibility for conducting clinical chart and patient billing audits for the purpose of Identifying and validating reported diagnoses for Medicare/Medicare Advantage and ACO health plan members.

Requirements:

• High School Diploma or GED
• RHIT - Registered Health Information Technologist or CPC-P - Certified Professional Coder (Physician) or CCS-P - Certified Coding Specialist (Physician), and CRC-Certified Risk Adjustment Coding Credential required
• Prior HCC/HHS experience with Medicare Risk Adjustment with three (3) years’ experience in medical coding

Skills:

• Strong analytical skills
• Ability to problem solve
• Detail oriented with high degree of accuracy