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Posted: 19-Jul-24
Location: Altamonte Springs, Florida
Salary: Open
Categories:
Internal Number: 24025355
Coding Specialist Risk Adjustment
All the benefits and perks you need for you and your family:
· Benefits from Day One
· Career Development
· Whole Person Wellbeing Resources
· Mental Health Resources and Support
Our promise to you:
Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.
Shift: Monday-Friday
Job Location: Virtual
The role you’ll contribute:
The Medicare Risk Adjustment Coding Specialist coordinates and supports retrospective and concurrent chart reviews in addition to education and chart retrieval for Health Plan audits and reports. Uses knowledge of Hierarchical Condition Categories (HCC) coding to translate, input, extract and validate medical record data.
- Review and assess documentation and accurately translates chronic conditions into the appropriate diagnosis code from inpatient and outpatient medical records
- Extracts data for Health Plan reports
- Inputs data collected from HCC programs
- Coordinates audits of Provider coding data
- Responsible for scheduling of audits
- Sends Provider the list for chart reviews and provides follow-up communication
- Assists in obtaining medical records from Providers to support audits requested by Health Plans
- Assists in coordinating Physician and staff training sessions
The expertise and experiences you’ll need to succeed:
Minimum qualifications:
- Minimum of three years of healthcare experience
- Minimum of 3 years’ experience in HCC coding
- Experience with Medicare risk adjustment, Hierarchical Condition Categories (HCC), coding, billing, auditing and various healthcare payers.
LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:
-
CPC, CCS (Certified Professional Coder), or CRC
Preferred experience:
- Prior risk adjustment and medical record review experience
- Strong ambulatory background with a focus on diagnostic coding
- Experience with Medicare risk adjustment, Hierarchical Condition Categories (HCC), coding, billing, auditing and various healthcare payers.
