Certified Risk Adjustment Coding Specialist

Trinity Health; Livonia (MI); Remote; USD 33,000 - 50,000; Full time

Benefits offered by this job

Comprehensive medical/dental/vision

PTO and 403(b)

Educational assistance

Daily pay and referral incentives

Professional development

Job summary

Trinity Health is seeking a Certified Risk Adjustment Coding Specialist for a fully remote role. Primary duties include assigning ICD/CPT codes, abstracting data, and educating on documentation to support HCCs.

Training occurs in Livonia, MI for one week in person, with onsite training in the second week. Work hours are 8:00–4:30 or 7:30–3:30 Eastern, with comprehensive benefits and commitment to HIPAA and regulatory standards.

Qualifications

• High school diploma or equivalent required; 2 years of college coursework preferred.
• Must have one of the listed certifications (AAPC/AHIMA) or be pursuing certification.
• Two years of experience in a risk adjustment coding environment.
• Ability to verify and validate HCCs.
• Ability to educate providers on documentation and guidance.
• Knowledge of medical terminology, anatomy, physiology, and disease processes.
• Strong communication, problem-solving, customer service, critical thinking, and organizational skills.
• Proficiency with Microsoft Office; ability to use other required software.
• Travel to Livonia, MI home office or other locations may be required occasionally.

Responsibilities

• Evaluate medical records to identify diagnoses and procedures and assign ICD and CPT codes; abstract and validate information.
• Conduct documentation spot checks and respond to audit feedback.
• Ensure timely, accurate client care documentation for billing.
• Monitor records not completed timely; investigate and take action for records not coded, billed, or rejected.
• Stay updated on coding guidelines and reimbursement requirements.
• Maintain participant confidentiality and HIPAA compliance.
• Assure site staff compliance with regulations via record review and communication.

Skills

Communication skills

Problem solving

Customer service

Critical thinking

Organizational skills

MS Word / Excel / PowerPoint

Education

High school diploma or equivalent

2 years college coursework preferred

Certified Outpatient Coder

Certified Coding Specialist

Certified Professional Coder (AAPC)

Registered Health Information Technologist

Registered Health Information Administrator

Two years risk adjustment coding experience

Tools

MS Word

Excel

PowerPoint

Job description

Employment Type:

Full time

Shift:

Description:

CERTIFIED RISK ADJUSTMENT CODING SPECIALIST

Location: Trinity Health PACE Corp Michigan

Status: Full time Remote

Position Purpose:

The primary purpose of this position is to assign ICD/CPT codes to participant health information for data retrieval, analysis, and claims processing. Duties also include abstracting and validating data from medical records and providing education on documentation to support HCCs.

Position Details:

This is a fully remote position. Work hours will be 8 to 430 or 7 to 330 Eastern.

Training will take place in person in Livonia, MI for one week (expenses paid). Onsite training is required for position. Onsite training would take place during the 2nd week of employment.

What you will do:

• Evaluate medical records to identify diagnoses and procedures and accurately assigns and sequences ICD and CPT codes. Abstracts and validates information. Seeks out validating information as needed.

• Conduct documentation spot checks and respond to audit feedback.

• Ensure timely, accurate client care documentation for billing.

• Monitors and informs manager of records that are not completed timely. Monitors, investigates and takes appropriate action for records that are not coded, billed, or rejected.

• Stay updated on coding guidelines and reimbursement requirements.

• Maintains participant confidentiality and abides by HIPAA guidelines.

• Assures site staff compliance with federal/state and accreditation regulations through record review, case conferencing and communication.

Minimum Qualifications:

• High school diploma or equivalent required. 2 years of completed college coursework preferred.

• Must have one of the following certifications: Certified Outpatient Coder, Certified Coding Specialist, Certified Professional Coder thru AAPC or Registered Health Information Technologist or Registered Health Information Administrator thru AHIMA

• Must be certified or obtaining certification for Certified Risk Adjustment Coder thru AAPC. If not obtaining, must obtain within one year if hired.

• Two-years of experience in a risk adjustment coding environment required.

• Demonstrated the ability to verify and validate HCCs.

• Demonstrated the knowledge and ability to work with providers on education and guidance.

• Demonstrated knowledge of medical terminology, human anatomy and physiology, and diseases processes.

• Strong communication, problem-solving, customer service, critical thinking, and organizational skills.

• Comprehensive proficiency with Microsoft product suite (MS Word, Excel, Power Point, etc.); Ability to use other software as required to perform the essential functions of the job.

• Ability to prioritize workload.

• Position may require occasional travel to home office in Livonia, MI or other supported locations.

Position Highlights and Benefits:

• Comprehensive benefit including 1st Day medical coverage, dental, vision, paid time off, 403B and educational assistance.

• Access to daily pay and employee referral incentives.

• Supportive environment with a patient-centered focus.

• Opportunities for professional development.

Ministry/Facility Information

Trinity Health PACE provides high-quality care to seniors in the communities we serve. Our interdisciplinary team offers comprehensive services, allowing seniors to remain independent at home.

We are guided by core values of reverence, commitment, safety, justice, stewardship, and integrity.

Min Pay Range: 24.00

Max Pay Range: 36.00

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

Our Commitment to Diversity and Inclusion

Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.

EOE including disability/veteran