Risk Adjustment Consultant - Remote

Overview

The Risk Adjustment Consultant is responsible for reviewing and validating coding practices in accordance with Medicare, Medicaid, and Commercial guidelines, ensuring coding accuracy through thorough medical record reviews.

In Short

• Perform medical record audits for coding accuracy.
• Review provider documentation for compliance with coding standards.
• Provide education to providers on coding guidelines.
• Summarize and interpret audit findings for leadership.
• Collaborate with staff to address coding adjustments.
• Maintain knowledge of coding rules and CMS guidelines.
• Conduct pre-visit chart reviews and provider outreach.
• Identify trends and recommend corrective actions.
• Work independently with general supervision.
• Support revenue cycle operations for outpatient settings.

Requirements

• Certified Risk Adjustment Coder (CRC) or must obtain within 12 months.
• Two years of outpatient billing and coding experience.
• Associate’s degree preferred.
• Experience in primary care adult medicine is a plus.
• Excellent organizational and communication skills.
• Ability to work under pressure and meet deadlines.
• Strong interpersonal skills for team collaboration.
• Ability to research and resolve coding issues.
• Experience in auditing and coding education.
• Ability to interpret coding guidelines and regulations.

Benefits

• Comprehensive Total Rewards package.
• Support for health and financial security.
• Opportunities for career growth.
• Competitive pay aligned with experience and skills.
• Work in a leading integrated health system.