Ambulatory Risk Adjustment Coder: Precise HCC & Documentation

NorthShore University HealthSystem; Skokie (IL); On-site; USD 31,000 - 46,000; Full time

Benefits offered by this job

Career growth

Medical, Dental, Vision

Tuition reimbursement

Free parking

Wellness program

HSA options

Retirement with company match

Paid time off

Community involvement

Job summary

Endeavor Health in Skokie, IL seeks an Ambulatory Risk Adjustment Coding Specialist to identify and code HCCs in outpatient visits, ensuring documentation supports CMS risk scores. This role collaborates with ambulatory CDS and physicians to validate codes and improve documentation and coding accuracy.

The position requires a High School diploma, CRC certification within six months, and 2 years in healthcare.

Qualifications

• Education: High School Diploma required; Associates preferred.
• Certifications: CRC required within 6 months of hire.
• Experience: 2 years in healthcare setting.

Responsibilities

• Review/abstract HCC codes to ensure accuracy, highest specificity, and correct CMS-HCC risk score.
• Identify diagnosis and chart level impairments and opportunities for documentation improvement.
• Partner with ambulatory CDS and physicians to code charts for proper risk adjustment.
• Recommend process improvements to coding goals and outcomes.
• Assist onboarding of new coding specialists as needed.
• Maintain knowledge of ICD-10-CM, CMS docs, and regulations.
• Maintain minimum 95% accuracy on coding quality audits.
• Meet productivity requirements per project terms.
• Assign ICD-10-CM codes and assist with risk adjustment.
• Maintain knowledge of all HCC diagnoses per guidelines.
• Assist with special project work from Ambulatory Clinical Documentation Leadership.

Education

High School Diploma

Associates Degree

Job description

Endeavor Health in Skokie, IL seeks an Ambulatory Risk Adjustment Coding Specialist to identify and code HCCs in outpatient visits, ensuring documentation supports CMS risk scores. This role collaborates with ambulatory CDS and physicians to validate codes and improve documentation and coding accuracy.

The position requires a High School diploma, CRC certification within six months, and 2 years in healthcare.