
Risk Adjustment Coding Specialist
8 hours ago
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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