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Risk Adjustment Coding Specialist (Remote in New York State)

Lensa

City of Albany (NY)

Remote

USD 50,000 - 70,000

Full time

13 days ago

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Job summary

A leading company in healthcare is seeking a Risk Adjustment Coding Specialist to join their team remotely in New York State. This entry-level position involves reviewing medical records and coding diagnoses using ICD-10. Candidates should possess strong knowledge of medical terminology and coding standards, with certifications preferred. The role offers competitive salary and comprehensive benefits.

Benefits

Healthcare benefits

Paid time off

Flexible work arrangements

Qualifications

Minimum one year of experience in a healthcare setting preferred.
Strong knowledge of ICD-10 diagnosis and procedure codes required.
Ability to work remotely without direct supervision.

Responsibilities

Responsible for chart review and ICD-10 diagnosis coding.
Review medical records to identify accurate diagnosis codes.
Handle diagnosis code projects.

Skills

Medical terminology

Anatomy

Physiology

Problem-solving

Customer service

Attention to detail

Education

High school diploma or GED

Associate's degree

CCS/CCS-P certification

CPC/CPC-A certification

CRC credential

Tools

Microsoft Office Suite

Risk Adjustment Coding Specialist (Remote in New York State)

Be among the first 25 applicants 14 hours ago

Lensa is the leading career site for job seekers at every stage of their career. Our client, CDPHP, is seeking professionals. Apply via Lensa today!

Grounded by a compelling mission, core values, and compassion for people, CDPHP and its family of companies offer a strong foundation for a rewarding career. Established in 1984, CDPHP is a physician-founded, member-focused, and community-based not-for-profit health plan that offers high-quality affordable health insurance to members throughout New York. The company values people, quality, innovation, and community, and its corporate culture supports those values wholeheartedly. CDPHP is committed to fostering a culture of belonging and takes a holistic approach to diversity, equity, and inclusion. At CDPHP, employees have a voice and are encouraged to make an impact at both the company and community levels through engagement and volunteer opportunities. CDPHP invests in employees who share these values and invites you to be part of that experience.

The Risk Adjustment Coding Specialist will be responsible for chart review and ICD-10 diagnosis coding of risk adjustment eligible members. Responsibilities include reviewing medical records to identify accurate ICD-10 diagnosis codes, chart retrieval activities, and handling diagnosis code projects.

Qualifications

High school diploma or GED required; Associate's degree preferred.
CCS/CCS-P (Certified Coding Specialist) or CPC/CPC-A (Certified Coding Professional) required. If CCA or RN/LPN licensure, successful completion of AHIMA CCS/CCS-P or AAPC CPC certification within one year of employment is required.
CRC (Certified Risk Adjustment Coder) credential preferred.
Minimum one (1) year of experience in an HMO, Managed Care Organization, or healthcare setting preferred.
Strong knowledge of medical terminology, anatomy, physiology, and medical chart review required.
Knowledge of ICD-10 diagnosis and procedure codes, CPT codes, Revenue codes, and HCPCS codes required.
Experience coding using an ICD-10-CM code book (without encoder software) required.
Working knowledge of HIPAA requirements, recognizing the importance of privacy, security, and confidentiality of medical information required.
Chronic Conditions knowledge preferred.
Experience with claims adjudication, billing, enrollment systems, and product or pricing is preferred.
Proficiency with Microsoft Office Suite (Word, Excel, Outlook, PowerPoint) required.
Experience with Clinical Documentation Improvement preferred.
Demonstrated knowledge of medical record review and diagnosis coding within the health insurance industry.
Ability to research, analyze, interpret CMS and State coding guidelines, and apply them to chart review, coding, and auditing.
Proactive problem-solving skills and ability to recommend and implement solutions.
Excellent customer service skills and ability to develop relationships internally and externally.
Ability to work with and maintain confidential information.
Excellent verbal and written communication skills.
Flexibility to adapt to a fast-paced environment.
Strong organizational and planning skills.
Attention to detail and completeness.
Successful experience working remotely without direct supervision.

CDPHP offers competitive salary ranges with room for growth, including incentive payments and comprehensive benefits such as healthcare, paid time off, and flexible work arrangements. Learn more at CDPHP Benefits.

As an Equal Opportunity/Affirmative Action Employer, CDPHP does not discriminate based on race, color, creed, religion, sex, sexual orientation, gender identity, age, national origin, marital status, disability, and other protected characteristics. All qualified applicants will receive consideration without regard to these factors.

Additional Details