HCC/Risk Adjustment Coder

HireTalent - Staffing & Recruiting Firm; United States; Remote; USD 60,000 - 80,000; Full time

Job summary

A leading staffing firm is seeking a Quality Review & Audit Analyst to perform remote medical record reviews and coding audits. Candidates should have a strong background in HCC/Risk Adjustment and relevant coding certifications. The position offers a pay rate of $25 per hour and requires flexibility in schedule for remote work.

Qualifications

• Minimum 2 years of HCC/Risk Adjustment experience.
• Must possess relevant Coding Certification.
• Strong communication and organization skills required.

Responsibilities

• Conduct medical records reviews for coding accuracy.
• Perform audits to ensure compliance and identify gaps.
• Collaborate with stakeholders on coding education.

Skills

HCC/Risk Adjustment experience

Microsoft Office Experience

Excellent Written and Verbal communication skills

Education

High School Diploma or equivalent

Coding Certification (CPC, CCS-P, CCS-H, RHIA)

Tools

ICD-10-CM coding guidelines

Microsoft Excel

Adobe Acrobat

Job description

1 day ago Be among the first 25 applicants

HireTalent - Staffing & Recruiting Firm provided pay range

This range is provided by HireTalent - Staffing & Recruiting Firm. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base pay range

$25.00/hr - $25.00/hr

Direct message the job poster from HireTalent - Staffing & Recruiting Firm

Duration – 04 months – (potential to Extend)

Pay - $25/hr on W2

Schedule Notes:

M-F: 9AM-5PM EST

Start time schedule flexible after training, no earlier than 7AM EST and no later than 9AM EST (with consecutive 8-hour shift)

Responsibilities:

This position is 100% remote and candidates can be sourced from across the US as long as they're able to support the EST schedule.

Candidates must have a quiet and private working environment.

Candidates must have a reliable, high-speed internet connection.

Candidates cannot have any pre-planned/scheduled time off during the first 30 days of assignment.

Conduct medical records reviews with accurate diagnosis code abstraction in accordance with Official Coding Guidelines and Conventions, IFP Coding Guidelines and Best Practices, HHS Protocols and any additional applicable rule set.

• Utilize HHS’ Risk Adjustment Model to confirm accuracy of Hierarchical Condition Categories (HCC)identified from abstracted ICD-10-CM diagnosis codes for the correct Benefit Year.
• Apply longitudinal thinking to identify all valid and appropriate data elements and opportunities for datacapture, through the lens of HHS’ Risk Adjustment.
• Perform various documentation and data audits with identification of gaps and/or inaccuracies in riskadjustment data and identification of compliance risks in support of IFP Risk Adjustment (RA) programs,including the Risk Adjustment Data Validation (RADV) audit and the Supplement Diagnosis submissionprogram. Inclusive of Quality Audits for vendor coding partners.
• Collaborate and coordinate with team members and matrix partners to facilitate various aspects of codingand Risk Adjustment education with internal and external partners.
• Coordinate with stake holders to execute efficient and compliant RA programs, raising any identified risksor program gaps to management in a timely manner.
• Communicate effectively across all audiences (verbal & written).
• Develop and implement internal program processes ensuring CMS/HHS compliant programs, includingcontributing to IFP Coding Guideline updates and policy determinations, as needed.

Skills/Requirements:

TOP 3 NON-NEGOTIABLE SKILLS (OUTSIDE OF CERTIFICATION)

- HCC/Risk Adjustment experience (2 years+)

- Microsoft Office Experience

- Excellent Written and Verbal communication skills

• Experience with medical documentation audits and medical chart reviews and proficiency with ICD-10-CMcoding guidelines and conventions
• Familiarity with CMS regulations for Risk Adjustment programs and policies related to documentation andcoding compliance, with both Inpatient and Outpatient documentation
• HCC coding experience preferred
• Computer competency with excel, MS Word, Adobe Acrobat
• Must be detail oriented, self-motivated, and have excellent organization skills
• Understanding of medical claims submissions is preferred
• Ability to meet timeline, productivity, and accuracy standards
• Experience working in a remote environment
• Excellent and clear written and verbal communication skills

Education:

The Quality Review & Audit Analyst will have a high school diploma and at least 2 years’ experience in one of the following Coding Certifications by either the American Health Information Management Association (AHIMA) or the American Academy of Professional Coders (AAPC):

• Certified Professional Coder (CPC)
• Certified Coding Specialist for Providers (CCS-P)
• Certified Coding Specialist for Hospitals (CCS-H)
• Registered Health Information Administrator (RHIA)

Education:

High School Diploma or equivalent

Seniority level

• Seniority level

  Associate

Employment type

• Employment type

  Contract

Job function

• Job function

  Customer Service

• Industries

  Hospitals and Health Care

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