Ambulatory Risk Adjustment Coding Specialist

Endeavor Health; Skokie (IL); Presencial; USD 67.910.000 - 101.865.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Premium pay (shift/on-call)

Incentive pay

Annual increases based on performance

Career growth opportunities

Tuition reimbursement

Free parking

Health Savings Account options

Retirement options with company match

Paid time off and holiday pay

Wellness program savings plan

Descripción de la vacante

Endeavor Health seeks an Ambulatory Risk Adjustment Coding Specialist in Skokie, IL. The role focuses on identifying and coding HCCs during physician outpatient visits, ensuring documentation supports the CMS risk score.

The candidate will work with ambulatory CDS and physicians, verify ICD-10-CM compliance, and maintain coding accuracy while meeting productivity targets. CRC is required within 6 months of hire.

Formación

• 2 years experience working in healthcare or professional business environment.
• CRC certification required within 6 months of hire.
• Strong knowledge of ICD-10-CM codes and CMS guidelines.

Responsabilidades

• Review/abstract HCC codes for accuracy and specificity.
• Identify diagnosis and chart level impairments for documentation improvements.
• Collaborate with ambulatory CDS and physicians to ensure proper coding.
• Suggest process improvements to coding goals and outcomes.
• Assist onboarding of new coding specialists as needed.
• Maintain current ICD-10-CM knowledge and CMS documentation requirements.
• Aim for at least 95% accuracy on coding quality audits.

Conocimientos

Healthcare experience

HCC coding

ICD-10-CM coding

Educación

High School Diploma

Associates Degree

Descripción del empleo

Hourly Pay Range: $23.70 - $35.55 - The hourly pay rate offered is determined by a candidate's expertise and years of experience, among other factors.

Position Highlights

• Position: Ambulatory Risk Adjustment Coding Specialist
• Location: Skokie, IL
• Full Time
• Hours: Monday-Friday, [hours and flexible work schedules]

Brief Overview

Our Ambulatory Risk Adjustment Coding Specialist I plays a key role in identifying HCC codes within physician outpatient visits and ensuring they are coded accurately and to the highest specificity. They additionally will verify that documentation requirements are met to validate the HCC diagnosis code. Working closely with the ambulatory clinical documentation specialist (CDS), they will clinically verify the accuracy of HCC codes. Using compliant query guidelines, the coding specialist will query the physician should documentation need clarification or specification. The coding specialist is expected to maintain current knowledge of the ICD-10-CM codes and guidelines and meet minimum productivity requirements outlined by team leadership.

What you will do

• Review/abstract HCC codes to ensure they are coded accurately, to the highest specificity possible, and make sure the required MEAT is documented, resulting in the correct CMS-HCC risk score
• Identify diagnosis and chart level impairments and documentation improvement opportunities for provider education
• Responsible for partnering with ambulatory clinical documentation specialists and physicians to properly code patient charts to ensure appropriate risk adjustment
• Assist coding leadership by making recommendations for process improvements to further enhance coding goals and outcomes
• Assists the coding team leads with onboarding new coding specialists to the role as needed.
• Maintain current knowledge of ICD-10-CM codes, CMS documentation requirements, and state and federal regulations
• Consistently maintain a minimum 95% accuracy on coding quality audits
• Meet minimum productivity requirements as outlined by the project terms
• Utilizes technical coding expertise to assign appropriate ICD-10-CM diagnosis codes, as well as assist in appropriate assignment of risk adjustment
• Maintains advanced knowledge of coding all HCC diagnoses from the medical record in accordance with the ICD-10-CM coding guidelines
• Assists with and completes special project work as assigned by Ambulatory Clinical Documentation Leadership

What you will need

• Education: High School Diploma required, Associates Degree preferred
• Certifications: CRC required within 6 months of hire
• Experience: 2 years experience working in healthcare or professional business environment

Benefits (For full time or part time positions)

• Premium pay such as shift, on call, holiday and more based on an employee’s job (For eligible positions)
• Incentive pay for select positions
• Opportunity for annual increases based on performance
• Career Pathways to Promote Professional Growth and Development
• Various Medical, Dental, Pet and Vision options
• Tuition Reimbursement
• Free Parking
• Wellness Program Savings Plan
• Health Savings Account Options
• Retirement Options with Company Match
• Paid Time Off and Holiday Pay
• Community Involvement Opportunities