Certified Risk Adjustment Coding Specialist

Trinity Health; United States; Remote; USD 33,000 - 50,000; Full time

Benefits offered by this job

Medical coverage

Dental

Vision

Paid time off

403B

Educational assistance

Daily pay

Referral incentives

Professional development

Job summary

Trinity Health PACE seeks a remote Certified Risk Adjustment Coding Specialist to assign ICD/CPT codes for participants, abstract and validate data, and educate on documentation to support HCCs. Training occurs onsite in Livonia, MI for one week with latter in-person sessions.

Work hours are 8:00–4:30 or 7:30–3:30 Eastern; full-time remote status applies. Minimum qualifications include relevant certifications and two years in risk adjustment coding.

Qualifications

• High school diploma or equivalent required; 2 years of 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 obtain certification for Certified Risk Adjustment Coder thru AAPC within one year if hired.
• Two years of experience in a risk adjustment coding environment required.
• Strong knowledge of medical terminology and anatomy; ability to educate providers on documentation.

Responsibilities

• Evaluate medical records to identify diagnoses and procedures and accurately assign and sequence ICD and CPT codes.
• Abstract and validate information; seek validating information as needed.
• Conduct documentation spot checks and respond to audit feedback.
• Ensure timely, accurate client care documentation for billing.
• Monitor records for timely completion and address un-coded or rejected records.
• Stay updated on coding guidelines and reimbursement requirements.
• Maintain confidentiality and HIPAA compliance.
• Ensure site staff compliance with regulations through review and communication.

Skills

ICD/CPT coding

HCC validation

Communication skills

Problem solving

Microsoft Word/Excel

Education

High school diploma

Two years college coursework preferred

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.