Senior Risk Adjustment Coder - HCC & CMS Expert

Universal Health Services, Inc.; Reno (NV); On-site; USD 85,000 - 110,000; Full time

Benefits offered by this job

Loan Forgiveness Program

Competitive Compensation & Generous PT

Excellent Medical, Dental, Vision and

401(K) with company match and stock

SoFi Student Loan Refinancing

Career development opportunities

Job summary

Prominence Health, a value-based care organization, seeks a Senior Coder to review medical records and ensure accurate coding for diagnosis and service codes across partner practices. The role involves pre, post, and wraparound visit input and may require occasional onsite work and travel for provider education.

The ideal candidate has CMS coding knowledge, 2+ years in Risk Adjustment Coding, and CRC/AAPC credentials, with bilingual Spanish preferred and experience navigating EMR systems.

Qualifications

• CMS coding and documentation guidelines knowledge
• HCC risk adjustment coding experience
• CRC certification required
• AHIMA or AAPC credentialed (CCS, CPC or RHIT)
• 2+ years in Risk Adjustment Coding
• Experience with multiple EMRs and ability to navigate EMR applications
• Strong understanding of CMS Coding and Documentation Guidelines
• HCC coding proficiency
• MS Office proficiency (Word/Excel/Outlook)
• Clinical knowledge of disease processes and related procedures
• Inpatient admission criteria and Medicare reimbursement knowledge preferred
• Medical office experience preferred
• Ability to read and write effectively in English; Spanish preferred

Responsibilities

• Review documentation and coding of medical records to ensure accuracy
• Collaborate with provider offices to report diagnoses and service codes accurately
• Support risk adjustment and quality measurement programs
• Handle pre, post and wraparound visit input
• Occasionally onsite at provider offices and potential travel for training
• Maintain reliable communication to accommodate providers’ schedules

Skills

CMS coding knowledge

HCC risk adjustment coding

English writing/reading

Spanish language bonus

Attention to detail

Education

Medical records / billing experience

Tools

EMR systems navigation

MS Office proficiency

Databases

Job description

Prominence Health, a value-based care organization, seeks a Senior Coder to review medical records and ensure accurate coding for diagnosis and service codes across partner practices. The role involves pre, post, and wraparound visit input and may require occasional onsite work and travel for provider education.

The ideal candidate has CMS coding knowledge, 2+ years in Risk Adjustment Coding, and CRC/AAPC credentials, with bilingual Spanish preferred and experience navigating EMR systems.