Employer Industry: Health Care Services

Why Consider this Job Opportunity:
- Opportunity for career advancement and growth within the organization
- Fully remote role, allowing for flexibility in work location
- Chance to make a positive impact on health care documentation and accuracy
- Collaborative work environment with a focus on teamwork and excellence
- Competitive pay and benefits package
- Engage in training and development of junior clinical staff

What to Expect (Job Responsibilities):
- Analyze member clinical charts and diagnostic data to assess coding accuracy and identify improvement opportunities
- Perform prospective chart coding reviews and recommend solutions for quality and accuracy enhancement
- Train new clinical analysts and guide staff in risk adjustment procedures and policies
- Identify trends in provider coding and documentation, communicating findings effectively
- Provide clinical and coding guidance for provider education and communication materials

What is Required (Qualifications):
- RN license required
- CPC (Certified Coding Professional) credential required
- CRC (Certified Risk Adjustment Coder) credential required; must obtain within one year of hire
- Minimum of 5+ years of experience in risk adjustment coding activities in a Medicare/ACA or provider organization
- Expert knowledge of risk adjustment, HCC, medical terminology, and medical chart review required

How to Stand Out (Preferred Qualifications):
- Demonstrated ability to research and interpret CMS coding and documentation guidelines
- Experience in coding guideline and policy implementation
- Knowledge of ICD-9/ICD-10 diagnosis and procedure codes, CPT codes, Revenue codes, and HCPCS codes
- Strong organizational and planning skills
- Ability to function independently while cooperating with team members

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