Strategic Risk Adjustment Coder for Primary Care

Cano Health LLC; United States; On-site; USD 70,000 - 95,000; Full time

Job summary

Cano Health LLC in the United States is seeking a Risk Adjustment Coder to identify, assess, monitor, and document claims and encounter coding information related to Clinical Condition Categories. You will verify accuracy and support coding decisions in accordance with documentation policies.

Responsibilities include reviewing medical records for CMS HCC coding, preparing charts with Excel, submitting encounters timely, and collaborating with Primary Care Providers.

Qualifications

• Two (2) years prior medical coding experience.
• Proficient in Microsoft Word and Excel.
• Strong organization and process management skills.
• Strong collaboration and relationship building skills.
• High attention to detail.
• Excellent written and verbal communication skills.
• Ability to learn new tasks and concepts.
• CPC, CPC-A or CCS-P, CRC Coding Certification.

Responsibilities

• Review medical record information to identify all appropriate coding based on CMS HCC categories.
• Prepare the medical charts and track patient information via Excel spreadsheets.
• Complete appropriate paperwork/documentation/system entry regarding claim/encounter information.
• Provide coding support, education and training related to quality of documentation, level of service and diagnosis coding consistent with established coding guidelines and standards.
• Provide real time support and coordination with Primary Care Providers and Care Coordinators for MRA coding, HEDIS and STARS.
• Monitor coding changes to ensure that most current information is available.
• Work HCC suspect reports.
• Accurately code and submit encounters on a timely basis.
• Researching and addressing code questions for multiple provider offices as directed.
• Update the Director on the status on a weekly basis.
• Notifies Patient Experience Manager if annual wellness visits for patients have not been scheduled.
• Travel to offices as necessary to complete on-site chart reviews.
• Performs post-audits on assigned offices and notifies office contact when codes are not addressed for provider review.
• Support and participate in process and quality improvement initiatives.
• Assists with billing claims as assigned.

Skills

Medical coding

CMS HCC

Excel

Attention to detail

Communication skills

Education

CPC, CCS-P, CRC Certification

Job description

Cano Health LLC in the United States is seeking a Risk Adjustment Coder to identify, assess, monitor, and document claims and encounter coding information related to Clinical Condition Categories. You will verify accuracy and support coding decisions in accordance with documentation policies.

Responsibilities include reviewing medical records for CMS HCC coding, preparing charts with Excel, submitting encounters timely, and collaborating with Primary Care Providers.