Value-Based Care Coder: Risk Adjustment Expert

Accompany Health, Inc.; United States; Remote; USD 44,000 - 50,000; Full time

Job summary

Accompany Health is seeking a Value Based Care (VBC) Coder to support concurrent review, compliant query generation, and accurate documentation to optimize risk adjustment payments. The role requires CPC or CRC certification and 3+ years of medical coding experience, preferably in risk adjustment.

You will collaborate with care teams and field staff, contribute to reporting improvements, and stay current with ICD-10-CM and CMS guidelines.

Qualifications

• Current certification as a CPC, CRC, or equivalent.
• 3+ years of recent, relevant work experience in medical coding, preferably in risk adjustment.
• Thorough understanding of medical coding guidelines and regulations including compliance, reimbursement, and the impact of diagnosis documentation on risk adjustment payment models.
• Subject matter expertise on the CMS HCC Risk Adjustment program, methodology, and impact to value-based contracts.

Responsibilities

• Concurrent review and feedback after face-to-face visit (in person or via telehealth) to ensure coding and documentation accurately captures patient health status.
• Compliant query generation when conflicts or clarification is needed in documentation, prior to claim submission.
• Corrected claim generation when compliant note amendments are completed.
• Provide guidance to field staff and practices regarding general coding, documentation and risk adjustment best practices.
• Partner with internal stakeholders to improve reporting and analytics tools to drive improvements in the accuracy and completeness of clinical documentation and diagnosis coding.
• Reviews annual mapping updates of ICD-10 CM crosswalk from CMS Website.
• Other duties as assigned.

Skills

CPC certification

CRC certification

Medical coding

HCC coding

Tools

athenahealth

GSuite

Job description

Accompany Health is seeking a Value Based Care (VBC) Coder to support concurrent review, compliant query generation, and accurate documentation to optimize risk adjustment payments. The role requires CPC or CRC certification and 3+ years of medical coding experience, preferably in risk adjustment.

You will collaborate with care teams and field staff, contribute to reporting improvements, and stay current with ICD-10-CM and CMS guidelines.