Senior Risk Adjustment Coding Specialist
| Company | Homeward Health |
|---|---|
| Location | Austin, TX, USA, San Mateo, CA, USA, Chicago, IL, USA, Minneapolis, MN, USA |
| Salary | $60000 – $78000 |
| Type | Full-Time |
| Degrees | |
| Experience Level | Senior |
Requirements
- 5 years of experience in medical coding, healthcare education, or a related field, with a strong focus on Medicare risk adjustment
- Certified Professional Coder (CPC) or Certified Risk Adjustment Coder (CRC) certification
- In-depth knowledge of Medicare & Medicaid risk adjustment methodology and coding guidelines
- Strong understanding of ICD-10-CM diagnosis coding
- Excellent communication skills
- Familiarity with electronic health record (EHR) systems
- Knowledge of healthcare compliance, regulations, and billing practices
- Analytical and problem-solving skills
Responsibilities
- Conduct regular audits of medical records, coding, and documentation to identify areas of improvement. Provide feedback and coaching to clinicians to address deficiencies.
- Collaborate with clinicians and support staff to identify opportunities for improving documentation to support accurate coding, risk adjustment, and compliance.
- Stay updated with the latest CMS (Centers for Medicare and Medicaid Services) risk adjustment guidelines and regulations to ensure education materials and training programs are current.
- Promote and maintain accurate and complete coding practices that reflect the severity and complexity of patients’ conditions to optimize risk adjustment factors.
- Ensure adherence to all regulatory requirements, including Medicare, Medicaid, and CMS guidelines, and provide guidance on avoiding fraud, waste, and abuse in coding and documentation.
- Collaborate with quality improvement teams to integrate risk adjustment coding best practices into healthcare processes and improve the overall quality of care.
- Communicate changes in risk adjustment coding policies and guidelines to staff, as well as assist in resolving coding-related issues.
Preferred Qualifications
- Additional AAPC or AHIMA certification (RHIA, RHIT, CDIP etc.)
- Approved instructor certification through AAPC or AHIMA
- Experience with risk adjustment technology solutions and risk adjustment vendors
- Previous experience building from the ground up on a small, fast-paced team