The Senior Risk Adjustment Coding Specialist would help in setting work distribution across production coders, complete and drive audits (internal and external regulatory audits), update our coding guidelines, collaborate with coding vendors, and present chart review and audit findings. The client can hire full time employees in the following states:
- Arizona
- Colorado
- Florida
- Idaho
- Illinois
- Indiana
- Iowa
- Kansas
- Louisiana
- Maryland
- Montana
- Nebraska
- Nevada
- New York
- North Carolina
- Ohio
- Oregon
- Pennsylvania
- Tennessee
- Texas
- Washington
- Wyoming
Requirements
- CRC
- 5+ years (not necessarily consecutive) of Risk Adjustment Coding – this is a Senior role (the current manger’s “right hand” person)
- Has more than just doing RA/Coding at a Physicians/Doctor’s office, must have vendor or health plan experience
- Peer Auditing experience and giving feedback to others on the team
- Knowledge of acceptable medical record standards and criteria in the context of risk adjustment data validation (RADV) audit (experience with HHS RADV and CMS RADV preferred)
- Strong written and verbal communication skills; able to communicate with and collaborate effectively with physicians, allied health care providers, executive leadership, and external vendors
- Ability to multi-task and deal with complex assignments on a frequent basis; Strong organizational, time management skills
- Ability to design and update provider feedback report templates
- Strong analytical skills and the ability to interpret, evaluate and formulate action plans based upon data
- Proficiency and experience with electronic medical record (EMR) software and Microsoft Office products
- Medicare/Medicaid preferred, not required
