Employer Industry: Healthcare

Why consider this job opportunity:
- Competitive salary with potential for bonuses
- Opportunity for career advancement and growth within the organization
- Fully remote position with flexibility to work from home
- Engage in impactful projects that enhance healthcare quality and accuracy
- Supportive work environment focused on teamwork and collaboration
- Chance to make a positive difference in the health and well-being of communities

What to Expect (Job Responsibilities):
- Analyze member clinical charts, diagnosis data, and coding accuracy for Medicare Advantage and Commercial HIX plans
- Conduct prospective chart coding reviews and provide solutions for improvement
- Identify and communicate trends in provider coding and documentation
- Guide staff in the Population Health department on risk adjustment procedures and issues
- Participate in corporate-wide projects to enhance clinical data collection

What is Required (Qualifications):
- CPC (Certified Coding Professional) credential required
- CRC (Certified Risk Adjustment Coder) credential required, to be obtained within one year of hire
- Minimum 3+ years of experience in risk adjustment coding activities in a Medicare/ACA or provider organization
- Strong knowledge of risk adjustment, Hierarchical Condition Category (HCC), and medical terminology
- Demonstrated ability to research, analyze, and apply CMS coding and documentation guidelines

How to Stand Out (Preferred Qualifications):
- RN license preferred but not required
- Experience in coding guideline and policy implementation
- Knowledge of ICD-9 / ICD-10 diagnosis and procedure codes, CPT codes, Revenue codes, and HCPCS codes
- Excellent organizational and planning skills
- Strong verbal and written communication skills

#Healthcare #RiskAdjustment #RemoteWork #CareerOpportunity #CodingExpertise

We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately.
We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.