HCC Risk Adjustment Coder (Clinical Operations Specialist) - Remote

Overview

The HCC Risk Adjustment Coder (Clinical Operations Specialist) is responsible for performing duties related to risk adjustment coding and audit initiatives in a remote setting.

In Short

• Review medical records and assist with backlog.
• Work on clinical pends with a goal to clear within 72 hours.
• Update training course material for medical record abstraction.
• Review training test scores and provide feedback.
• Maintain an accuracy score of 95% on all work submitted.
• Conduct remote mentoring and coaching sessions.
• Assist in training on Reveleer technology.
• Monitor and maintain coding accuracy.
• Stay updated with coding protocols and guidelines.
• Communicate with the Clinical Management team regarding workload.

Requirements

• Current Coding Certification (CPC, CPC-P, etc.) through AAPC and/or AHIMA.
• Minimum of 3 years coding experience, especially in Medicare and Commercial Risk Adjustment.
• Experience in facility coding preferred.
• Experience in Health Plan Risk Adjustment Data Validation Audit preferred.

Benefits

• Work in a remote environment.
• Flexible working hours.
• Opportunity for professional development and training.
• Collaborative team environment.
• Access to proprietary technology and resources.