Risk Adjustment Coding Specialist (CRC or CPC)

Privia Health; Houston (TX); On-site; USD 60,000 - 70,000; Full time

Job summary

Join a forward-thinking healthcare organization as a Risk Adjustment Coding Specialist. In this dynamic hybrid role, you will play a crucial part in enhancing documentation accuracy and compliance within a collaborative team. Your expertise in ICD-10 coding and chart auditing will directly impact patient care quality and provider efficiency. This innovative firm offers a supportive environment where your contributions will help shape the future of healthcare delivery. If you are passionate about coding and eager to make a difference, this opportunity is for you!

Benefits

Annual Bonus

Flexible Work Schedule

Professional Development Opportunities

Qualifications

• CPC and CRC certifications required; two years of ICD-9-CM/ICD-10-CM coding experience.
• Strong analytical and interpersonal skills are essential for success.

Responsibilities

• Perform chart audits to track ICD-10 coding and identify improvement opportunities.
• Ensure provider documentation supports accurate code selection and compliance.

Skills

ICD-10 Coding

Chart Auditing

Documentation Evaluation

Interpersonal Skills

Analytical Skills

Communication Skills

Research Skills

Education

High School Diploma

Associate’s Degree

Tools

AthenaHealth EHR

Job description

Company Description

Privia Health is a national physician platform transforming the healthcare delivery experience. We provide tailored solutions for physicians and providers, creating value and securing their future. Through high-performance physician groups, accountable care organizations, and population health management programs, Privia works in partnership with health plans, health systems, and employers to better align reimbursements to quality and outcomes.

Job Description

This full-time position is a hybrid role that requires working in the office on Tuesdays and Thursdays at 1200 Binz St Suite 1490 Houston TX 77004. Mon, Wed, and Fri are typically work from home but may be in office on occasion.

We are currently recruiting for a Risk Adjustment Coding Specialist to join our Gulf Coast Population Health team. The successful candidate will have experience in both primary care and multispecialty and be responsible for ensuring provider documentation is complete and supports provider code selection.

Primary Job Duties:

• Performs chart audits to track ICD-10 coding and documentation to identify improvement opportunities and deficiencies related to Risk adjustment.
• Evaluate the record for consistency and adequacy in documentation. Ensure that the final diagnosis accurately reflects the care and treatment rendered and that there is appropriate supporting documentation.
• Identifies coding trends to be escalated to the coding and documentation educator and population health leadership.
• Performs chart audits and data submission on payor portals as part of payer program incentive programs.
• Performs a comprehensive review of the record to assure the presence of all parts such as patient and record identification, signatures and dates where required, and all other necessary data in the presence of all reports that appear to be indicated by the nature of the treatment rendered.
• Answers internal and external complex coding email questions daily.
• Maintains compliance standards in accordance with the Compliance policies.
• Accurately follows coding guidelines and legal requirements to ensure compliance with federal and state regulatory bodies.
• Performs other related duties, which may be inclusive, but not listed in the job description.

Knowledge of:

• Federal laws and regulations affecting coding requirements.
• Principles, practices, and methods of current coding certificate required.
• Knowledge of billing practices required.
• Knowledge of medical records, and EHR required.
• Extensive knowledge of official coding conventions and rules established by the American Medical Association (AMA), and the Center for Medicare and Medicaid Services (CMS) for assignment of diagnostic and procedural codes.
• Must comply with all HIPAA rules and regulations.

Qualifications

• High School Diploma: Associate’s degree preferred.
• AAPC Certified Professional Coder (CPC) certification is preferred, CPC and Certified Risk Adjustment Coder (CRC) is required.
• Two years experience using ICD-9-CM/ICD-10-CM coding.
• AthenaHealth EHR experience a plus.
• Excellent interpersonal skills, communication skills, analytical skills, and research skills.
• Strong ability to collaborate, be resourceful, and team skills.

The salary range for this role is $60,000 - $70,000 in base pay and exclusive of any bonuses or benefits. This role is also eligible for an annual bonus targeted at 10%. The base pay offered will be determined based on relevant factors such as experience, education, and geographic location.

All your information will be kept confidential according to EEO guidelines.