Risk Adjustment Coding Specialist

8 hours ago


Brisbane, Queensland, Australia beBeeCoding Full time $25,540 - $78,336

Job Title: Risk Adjustment Coding Specialist

The ideal candidate will oversee the entire chart review lifecycle, from scheduling access to submission of the RAPS file to CMS.

Responsibilities

  • Determine adequacy and correctness of medical documentation as it relates to risk; proactively identify and implement opportunities for improvement.
  • Serve as a resource regarding quality coding per guidelines and supervise the quality of internal and external coders.
  • Develop policies, procedures, operational workflows, auditing worksheets, and other documentation to support department processes concerning risk adjustment, risk mitigation, and RADV activities.
  • Educate and provide feedback to provider offices about medical record documentation and coding issues to facilitate accurate claims submissions and reduce RADV risk exposure.
  • Ensure all Level 1 coders maintain updated knowledge of coding requirements through continuing education and certification renewal.

Required Skills and Qualifications:

  • Strong knowledge of HCC coding and related regulations.
  • Excellent analytical and problem-solving skills.
  • Able to work independently with minimal supervision.
  • Familiarity with electronic health records (EHRs) and other healthcare software.

Benefits:

  • Opportunity to work in a dynamic and growing industry.
  • Chance to develop and implement new policies and procedures.
  • Collaborative and supportive work environment.

About This Role:

This is a remote opportunity that offers flexibility and work-life balance. The ideal candidate will be highly motivated, organized, and able to prioritize tasks effectively.



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