Risk Adjustment Coding Specialist

Gather Health; Boston (MA); Hybrid; USD 60,000 - 90,000; Full time

Job summary

Join a forward-thinking healthcare organization dedicated to transforming primary care for older adults. As a Risk Adjustment Coding Specialist, you will play a pivotal role in ensuring the accuracy of diagnosis documentation and coding, supporting value-based care initiatives. This position offers a unique opportunity to work within a mission-driven team, where your expertise in HCC coding and medical coding guidelines will directly impact patient care. Enjoy a flexible work environment with 75% remote work and a culture focused on compassion and collaboration. Be part of a team that values innovation and strives for generational health equity.

Benefits

Compassionate Work Environment

Flexible Work Schedule

Professional Development Opportunities

Qualifications

• 2+ years experience as a certified professional coder.
• Proficient in HCC coding and medical coding guidelines.

Responsibilities

• Ensure accurate coding and compliance with regulations.
• Review patient charts for accuracy and completeness.

Skills

HCC Coding

Medical Coding Guidelines

Interpersonal Skills

Microsoft Office Suite

Education

Certified Professional Coder (AAPC)

Certified Coding Specialist (AHIMA)

AS Degree in Accounting or Related Field

Tools

Microsoft Word

Microsoft PowerPoint

Microsoft Outlook

Microsoft Excel

Job description

Who is Gather Health?

We are a new and growing healthcare organization with a unique and innovative approach to healthcare. Our mission is to improve lives and communities through socially supported primary care for older adults. Our innovative business model allows our clinicians to treat the whole patient - not just their clinical needs. We do this by having a dedicated care team that supports our clinicians by addressing our patients’ social determinants of health and providing the highest quality of service possible. Our ultimate vision is creating generational health and equity for communities across the country, one patient at a time.

What is this role about?

Gather Health is seeking a Risk Adjustment Coding Specialist to join our growing team. This role is critical to ensuring the accuracy and completeness of diagnosis documentation and coding to support value-based care under Medicare Advantage and ACO REACH contracts. The ideal candidate has a deep understanding of HCC coding, is detail-oriented, and has strong interpersonal skills to provide feedback and education to PCPs. This role will is 75% remote, requiring periodic onsite time for provider 1:1, group education, and team meetings as needed.

What are some of the day-to-day duties?

- Making sure that codes are assigned correctly and sequenced appropriately as per government and insurance regulations

- Complying with medical coding guidelines and policies

- Reviewing patients’ charts and documents for verification and accuracy (prospective and Concurrent Chart Review)

- Maintaining productivity and quality standards as set by the company

- Communicating professionally with co-workers regarding clinical and reimbursement issues

- Reporting missing or incomplete documentation while working with the providers to fix documentation errors. Following up and clarifying any information that is not clear to PCPs.

What are the requirements for this position?

- Two (2)+ years previous experience as a certified professional coder

- Certified Professional Coder through the American Academy of Professional Coders (AAPC) or Certified Coding Specialist through the American Health - Information Management Academy (AHIMA)

- Proficient computer skills, Microsoft Office Suite (Word, PowerPoint, Outlook, and Excel).

What are the preferred, “nice to have” requirements?

- AS degree in accounting, health care administration, finance, business, or related field preferred

- Able to multitask, prioritize, and manage time efficiently

- Self-motivated and self-directed; able to work without supervision

- Excellent verbal, written, and interpersonal communication skills

Why should I join Gather Health?

·We are a mission-based organization that is passionate about changing the way seniors experience primary care

·Our business model is unique and on the cutting-edge of the primary care industry

·Our leadership team is comprised of experienced individuals who are committed to creating not only the best patient experience, but also an amazing employee experience for our colleagues

·We are intentionally building a strong company culture and providing a compassionate and joyful work environment

·The organization was conceptualized, founded, and launched by experienced co-founders with a track record of success in the healthcare space

Gather Health is an Equal Opportunity Employer. All employment decisions are made without regard to age, race, creed, color, religion, sex, national origin, ancestry, disability status, veteran status, sexual orientation, gender identity or expression, genetic information, marital status, citizenship status, or any other basis as protected by federal, state, or local law.