Risk Adjustment Coordinator, Remote, Baptist Health Integrated Care, FT, 08A-4:30P
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Overview
Job Description
The Risk coding Regional Auditor must support the Director of risk coding along with other team professionals working to provide pre and post visit review analysis for provider practices while providing risk coding education to healthcare providers to improve practice risk scores. He or she must relate in a professional manner to co-workers, hospital administrators, physicians, Medicare beneficiaries, and others to represent the department and the health system while working closely with other departments to achieve favorable outcomes. This position is responsible for chart review and up-coding workflows. The position will also require coordination of projects to ensure the success of the goals within the CIN organization. Supports the mission, vision, values and strategic goals of Baptist South Florida. Estimated pay range for this position is $25.37 - $32.22 / hour depending on experience. Degrees:
- High School,Cert,GED,Trn,Exper.
Licenses & Certifications:
- AAPC Certified Risk Adjustment Coder.
- AAPC Certified Professional Coder.
- AAPC Certified Professional Medical Auditor.
Additional Qualifications:
- Bachelors of Science degree preferred.
- Certified Professional Coder and/ or Certified Risk Adjustment Coder (CRC).
- CPMA certification must be obtained within 1 year of Hire.
- Required completion of an accredited certified coding specialist program.
- 2 years of clinic or hospital experience and/ or managed care experience.
- 1 years of experience in Risk Adjustment and HEDIS/Stars.
- Ability to interpret, analyze and abstract data/documentation.
- Comprehensive Knowledge of ICD-10-CM codes, Category II codes, COA measures, CMS documentation requirements, state and federal regulations including compliance and reimbursement and the impact of diagnosis coding on risk adjustment payment models.
- Ability to identify HCC improvement opportunities and educate clinical providers on proper clinical documentation, compliance, and coding guidelines.
- Intermediate level of proficiency in MS Office - Excel, PowerPoint, and Word.
- Ability to defend coding decisions to both internal and external audits.
- Strong organizational skills in multiple settings, as well as the ability to exercise judgement and initiative.
- Ability to work in a continuously changing environment.
Minimum Required Experience: 5 Years
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