Risk Adjustment Clinical Coding Specialist
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company
Since 2012, this client has been a trusted partner for the nation’s top health plans, health systems, post-acute care providers, and at-risk physician groups navigating the shift from volume to value. Their high-touch, proven care model fully supports patients from pre-acute through to the home. This client's patients can enjoy more days at home, and healthcare providers and health plans can significantly reduce costs specific to unnecessary care and readmissions.
overview
Risk Adjustment Clinical Coding Specialist We are looking for a professional with certification in medical coding who can jump in from day one. Our ideal candidate will be committed to organizing, managing, and ensuring the accuracy of health information data. OVERVIEW: Location: Greenville, South Carolina (preferred) with remote capabilities Start Date: On/Before November 1st Type: 6 month contract REQUIREMENTS: • High School Diploma, GED, or suitable equivalent at a minimum • 3+ years of work experience as Medical Coder for Risk Adjustment • American Academy of Professional Coders (AAPC)’s CPC and CRC Certifications highly preferred • Proficient computer skills • Excellent communication skills, both verbal and written • Strong interpersonal skills in order to communicate and build positive relationships with patients and staff • Ability to work with others while completing multiple tasks simultaneously • Ability to maintain confidentiality of information • Highly motivated, flexible, and adaptable to working in a dynamic environment • Proactive and collaborative cross-functional working style • Highest level of ethics and integrity RESPONSIBILITIES: • Conducting comprehensive reviews of medical charts for complete and accurate coding • Reviewing the clinical documentation completed by the providers and querying them for any updates to the medical records based on the highest degree of specificity and accuracy, and ensuring sign-off by providers • Timely workflow and processing of patient charts and encounters • Identifying opportunities for more complete documentation of medical encounters based on chart review and analytics provided by software • Identifying opportunities for reaching optimal Quality performance (i.e. STARS, HEDIS, MIPS) through chart review and development of patient-by-patient quality plans • Conducting and participating in training/education for providers to instill a culture of excellence related to medical documentation and coding • Communicating with insurance companies regarding disputes or appeals as it relates to coding • Conducting audits and coding reviews proactively • Participating in Quality Assurance and Peer Review processes