Clinical Risk Adjustment Coordinator

Bluebird Kids Health; West Palm Beach (FL); Remote; USD 60,000 - 80,000; Part time

Job summary

A pediatric healthcare organization is seeking a Clinical Risk Adjustment Coordinator to support their Continuity of Care program. This remote role involves retrospective clinical chart reviews, documentation to ensure compliance with program requirements, and collaboration with healthcare providers. Ideal candidates will have a clinical background and familiarity with EHR systems, particularly Athenahealth. Strong attention to detail and HIPAA compliance are essential. This position offers flexibility in a fully remote work environment.

Benefits

Flexible remote work

Opportunity to contribute to pediatric healthcare

Qualifications

• Clinical background required (RN, LPN).
• Experience with Athenahealth or other major EHR systems strongly preferred.
• Strong attention to detail and ability to follow complex workflows.

Responsibilities

• Conduct retrospective chart reviews for assigned patients.
• Accurately document condition status using standardized categories.
• Collaborate with nursing and provider teams for risk adjustment reporting.

Skills

Detail-oriented

Organizational skills

Communication skills

Experience with EHR systems

Knowledge of value-based care

Education

Clinical background (RN, LPN)

Tools

Athenahealth

Job description

Bluebird Kids Health is a dynamic organization that provides underserved communities with new access to value-based pediatric primary care. We are on a mission to provide exceptional care, so every child can thrive . We offer comprehensive, evidence-based primary and urgent care services to children and their families, with around-the-clock support. Our care model includes robust care coordination, chronic disease management, and other population health supports. Our success is measured by exceptional health outcomes, lower medical costs, outstanding child and family experience, and a rewarding environment for our clinicians and staff.

Role Summary

We are seeking a Clinical Risk Adjustment Coordinator to support our Continuity of Care (CoC) program. This role is primarily responsible for retrospective clinical chart review and accurate documentation to ensure compliance with program requirements. The coordinator will review pediatric patient charts and appointment agendas, identify care gaps, complete reports, and support providers in documenting and addressing pre-existing or suspected conditions. Provide insight into common care gaps and opportunities for process improvement, trends in care gaps and documentation to support care provided.

The ideal candidate will be detail-oriented, highly organized, and comfortable working in a fully remote environment while handling protected health information (PHI) in compliance with HIPAA standards. Familiarity with pediatrics, value-based care (VBC), and EHR systems such as Athenahealth is strongly preferred.

Key Responsibilities

• Temporary, per diem role with a minimum requirement of 10 hours per week, if requested by Bluebird Kids Health.
• Conduct retrospective chart reviews for assigned patients in Athenahealth, verifying identifiers, and reviewing clinical documentation.
• Review and update Continuity of Care (CoC) Appointment Agendas in health plan provider portals.
• Accurately document condition status using standardized categories.
• Identify incomplete documentation and escalate to providers for review using established workflows.
• Upload CoC Appointment Agenda PDFs to patient EHRs and annotate appropriately for upcoming or past encounters.
• Maintain case status tracking in the CoC Appointment Agenda Tracker to ensure accuracy and timeliness.
• Handle PHI securely - never storing patient data locally and ensuring compliance with HIPAA requirements at all times.
• Meet productivity expectations of reviewing an average of 3-6 patient cases per hour, depending on complexity.
• Collaborate with nursing and provider teams to support accurate and timely risk adjustment reporting.
• Identify and document trends and deficiencies in clinical documentation to improve accuracy
• Track risk adjustment data to identify trends, gaps, and opportunities for process improvement.

Qualifications

• Clinical background required (RN, LPN), but highly organized non-clinical candidates with strong chart review experience will be considered.
• Experience with Athenahealth or other major EHR systems is strongly preferred.
• Knowledge of pediatrics and/or value-based care programs as a plus.
• Strong attention to detail and ability to follow complex workflows.
• Excellent written communication and documentation skills.
• Comfort working in a remote environment with protected health information.
• Reliable high-speed internet and HIPAA-compliant workspace.

Technical Requirements

• Secure, high-speed internet connection.
• HIPAA-compliant workspace (including but not limited to private location, password-protected) devices, updated antivirus/security).
• Competitive hourly rate or salary commensurate with experience.
• Flexible, fully remote work environment.
• Opportunity to contribute to a mission-driven pediatric healthcare organization improving outcomes for children and families.

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