HCC Coding Analyst (CRC Certified) for Risk Adjustment

Alignment Health; United States; Remote; USD 59,000 - 88,000; Full time

Job summary

Alignment Health is seeking an experienced HCC Coding Analyst to interface with provider partners, audit RAPS submissions, and ensure CMS data accuracy in risk adjustment initiatives.

The role requires 3+ years in medical coding, certification, and experience with CMS guidelines; Epic/Allscripts proficiency is a plus. Pacific Time work hours apply in a fast-paced healthcare environment.

Qualifications

• Minimum 3+ years of coding in a medical group or health plan setting required; Professional Coding experience required. Minimum 1 year experience with strategic planning in risk mitigation.
• Work Hours: Pacific Standard Time
• Previous experience with Epic, Allscripts, EZCap is a plus
• Certified Coder licensed, HCC/Risk Adjustment experience, Athena EHR experience preferred

Responsibilities

• Monitors coding & abstracting quality by conducting/o coordinating audits to ensure quality and performance improvement.
• Develops, implements, evaluates & improves IPA educational tools for providers to capture acute and chronic conditions.
• Tracks & reports progress of audits to assure coding accuracy and CMS data quality.
• Supports Risk Adjustment Management in scheduling/training activities and maintains training records.
• Educates and updates risk adjustment materials based on CMS-HCC models and ICD-9/ICD-10 changes.
• Maintains a tracking tool for assigned IPA’s within Alignment Health's provider network.

Skills

Communication skills

Leadership

Reasoning

Problem solving

Report analysis

Education

Certified Coder

CCS

CCS-P

CPC

Tools

Epic

Allscripts

EZCap

MS Office

Job description

Alignment Health is seeking an experienced HCC Coding Analyst to interface with provider partners, audit RAPS submissions, and ensure CMS data accuracy in risk adjustment initiatives.

The role requires 3+ years in medical coding, certification, and experience with CMS guidelines; Epic/Allscripts proficiency is a plus. Pacific Time work hours apply in a fast-paced healthcare environment.