Clinical Risk Adjustment Medical Coders

Broadpath Healthcare Solutions, Inc.; United States; Remote; USD 60,000 - 80,000; Full time

Job summary

BroadPath Healthcare Solutions is hiring Clinical Risk Adjustment Medical Coders for their remote team. The role involves coding insurance claims, coordinating with providers, and ensuring compliance with regulatory requirements. Ideal candidates have medical coding certifications and experience in risk adjustment coding.

Qualifications

• 2-5 years' experience in Risk adjustment/HCC coding.
• Expert knowledge of Medicare severity adjustment processes.
• 1+ years experience with Risk Adjustment in Medicare Advantage.

Responsibilities

• Accurately code insurance claims ensuring compliance.
• Coordinate with internal departments and vendors.
• Ensure timely completion of medical record requests.

Skills

Critical thinking

Risk adjustment coding

Data extraction

Financial reconciliation

Analytics

Education

Valid Medical Coder certification from AHIMA or AAPC

Job description

Overview

BroadPath is immediately hiringClinical Risk AdjustmentMedical Codersto join our remote team. Our work at homeClinical Risk AdjustmentMedical Coderswill be responsible for accurately coding insurance claims into the database system, ensuring compliance with all regulatory requirements and facilitating seamless claims processing.

Responsibilities

• Follow up with providers as necessary
• Coordinate with internal departments and vendors
• Ensure timely completion of medical record request to meet departmental goals and CMS deadlines
• Supports quality improvement interventions by collecting medical records data
• Data extraction, financial reconciliation, and analytics
• Participate in discussions with respect to ongoing projects
• Production and presentation of results to senior leaders
• Perform ad hoc analysis for multiple product lines
• Multi-tasking, ability to manage at macro level and dig deep into issues for successful resolution

Qualifications

Must have a valid Medical Coder certification from AHIMA or AAPC:

• Certified Coding Specialist (CCS), Certified Coding Specialist-Physician Based (CCS-P), and Risk Adjustment Coding (RAC)
• Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Risk Adjustment Coder (CRC), Certified Inpatient Coder (CIC)

Required Qualifications

• Minimum 2-5 years’ experience inRisk adjustment/HCC coding
• Must be able to identify risk adjustment codes/models
• Must be a critical thinker
• Expert knowledge of Medicare severity adjustment processes and tools
• 1+years of experience working withRisk Adjustmentin Medicare Advantage, Medicaid, and/or ACA

Preferred Qualifications

• Recent experience preferred (within last year)
• Experience with multiple vendors and/or health plans

Diversity Statement

At BroadPath, diversity is our strength. We embrace individuals from all backgrounds, experiences, and perspectives. We foster an inclusive environment where everyone feels valued and empowered. Join us and be part of a team that celebrates diversity and drives innovation!

Equal Employment Opportunity/Disability/Veterans

If you need accommodation due to a disability, please email us at [e-mail]. This information will be held in confidence and used only to determine an appropriate accommodation for the application process

BroadPath is an Equal Opportunity Employer. We do not discriminate against our applicants because of race, color, religion, sex (including gender identity, sexual orientation, and pregnancy), national origin, age, disability, veteran status, genetic information, or any other status protected by applicable law.

Compensation: BroadPath has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location.