Risk Adjustment Coding & Documentation Specialist

Performs compliance activities focused on risk adjustment in accordance with CMS and HHS. Reviews provider coding and conducts annual risk assessments, training, and auditing.

Requirements

• Associate degree required in healthcare administration, nursing, health information management, accounting, finance, or other related field
• 2 years of medical coding experience required
• One-year previous experience with paper and/or electronic medical records required
• Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Inpatient Coder (CIC), Certified Coding Specialist-Physician-based (CCS-P), Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA) certification required
• Must obtain Certified Risk Adjustment Coder (CRC) certification within two years of employment
• Prefer one-year experience with risk adjustment program in a Health Plan or Provider setting
• Prefer previous experience with CMS, HHS and/or CDPS+RX Hierarchical Condition Categories (HCC) models
• Prefer previous CMS and/or HHS Risk Adjustment Data Validation (RADV) experience

Benefits

• Medical, Dental, Vision plans
• Adoption, Fertility and Surrogacy Reimbursement up to $10,000
• Paid Time Off and Sick Leave
• Paid Parental & Family Caregiver Leave
• Emergency Backup Care
• Long-Term, Short-Term Disability, and Critical Illness plans
• Life Insurance
• 401k/403B with Employer Match
• Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education
• Student Debt Pay Down – $10,000
• Reimbursement for certifications and free access to complete CEUs and professional development
• Pet Insurance
• Legal Resources Plan