Risk Adjustment Coder — Drive Medicare Compliance

Providers; McAllen (TX); On-site; USD 70,000 - 95,000; Full time

Benefits offered by this job

Loan Forgiveness Program

Excellent health plans

401(k) with company match

Job summary

Prominence Health, an on-site risk adjustment coding role, seeks a coder to ensure accurate, compliant coding for Medicare risk adjustment and HEDIS data collection. The coder will review medical records, prepare charts for health assessments, and identify documentation opportunities for provider review.

Knowledge of HEDIS data collection is required. Minimum one year CMS HCC coding experience with ICD-10/CPT II proficiency and strong attention to detail is essential.

Qualifications

• CMS HCC risk adjustment coding experience required.
• ICD-10 and CPT II coding proficiency.
• CCS, CPC, CRC, or RHIT certification.

Responsibilities

• Perform post-review coding and documentation review for HEDIS.
• Prepare charts for health assessments and identify coding opportunities.
• Provide guidance on coding and documentation requirements related to charts.

Skills

Attention to detail

Independent work

Written & verbal communication

English proficiency

Education

High school diploma or GED

Associate degree preferred

Tools

Microsoft Office Suite

Job description

Prominence Health, an on-site risk adjustment coding role, seeks a coder to ensure accurate, compliant coding for Medicare risk adjustment and HEDIS data collection. The coder will review medical records, prepare charts for health assessments, and identify documentation opportunities for provider review.

Knowledge of HEDIS data collection is required. Minimum one year CMS HCC coding experience with ICD-10/CPT II proficiency and strong attention to detail is essential.