Employer Industry: Healthcare Services

Why consider this job opportunity:
- Fully remote position with flexibility in work location
- Opportunity for career advancement and growth within the organization
- Engage in impactful work that enhances healthcare quality and accuracy
- Supportive and collaborative work environment
- Competitive salary and benefits package, including training and development opportunities

What to Expect (Job Responsibilities):
- Analyze member clinical charts, diagnosis data, and CPT codes for accuracy and improvement opportunities
- Perform prospective chart coding reviews and recommend solutions for quality enhancement
- Identify trends in provider coding and documentation, providing guidance to staff
- Train new clinical analysts and educate providers on risk adjustment coding policies
- Participate in corporate projects aimed at improving clinical data collection

What is Required (Qualifications):
- RN license required
- CPC (Certified Coding Professional) credential required
- CRC (Certified Risk Adjustment Coder) credential required, to be obtained within one year of hire
- Minimum of 5+ years' experience in risk adjustment coding activities in 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, analyze, and interpret CMS coding and documentation guidelines
- Experience in coding guideline and policy implementation
- Knowledge of ICD-9 / ICD-10, CPT codes, Revenue codes, and HCPCS codes
- Strong organizational and planning skills

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