Certified Risk Adjustment Coding Specialist

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

Benefits offered by this job

Medical coverage from day one

Daily pay access

Employee referral incentives

Professional development opportunities

Job summary

Trinity Health PACE is seeking an ICD/CPT coder to assign codes from medical records and support HCCs for claims processing. This is a fully remote role with scheduled in-person training in Livonia, MI during the first week.

Work hours are 8:00-4:30 or 7:30-3:30 Eastern; occasional travel to home office may be required. The role emphasizes HIPAA compliance, data accuracy, and ongoing education on coding guidelines.

Qualifications

• High school diploma or equivalent required; 2 years of college preferred.
• Certifications: CPC/CSS or CSR or CPC thru AAPC or RHIT/RHIA thru AHIMA.
• Certified Risk Adjustment Coder within 1 year if hired.
• Two years of experience in risk adjustment coding.

Responsibilities

• Assign ICD and CPT codes from medical records and ensure proper sequencing.
• Abstract and validate information; respond to audit feedback.
• Support billing with timely, accurate documentation.
• Monitor records for timeliness and resolve coding/billing issues.
• Stay updated on coding guidelines and reimbursement requirements.
• Maintain HIPAA confidentiality and data protection.
• Educate providers on documentation to support HCCs.

Skills

Communication

Problem solving

Documentation

Organizational skills

HIPAA compliance

MS Word

Education

CPC/AAPC

RHIA/RHIT/AHIMA

Tools

MS Word

Excel

PowerPoint

Job description

Employment Type: Full time Shift: Description:

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.