01Overview
Job Description Summary
Responsibilities
Abstract and assign ICD10CM diagnosis codes supported in encounter documentation and work independently with minimal oversight from leadership or higherlevel coders.
Conduct retrospective audits of medical records to validate diagnosis coding accuracy, completeness, and claim submission quality.
Perform comprehensive reviews of provider actions within the ValueBased Alert Tool (VBAT) to identify outliers and improvement opportunities.
Analyze Medicare Risk Adjustment (MRA) data to identify coding or documentation patterns and assist in developing interventions at the provider or regional level.
Keep leadership aware of project activities through written and oral updates;
proactively identify project risks.
Consistently meet or exceed accuracy and productivity benchmarks.
May be assigned additional projects or a higher workload volume than a Level I specialist.
How will you make an impact & Requirements
RISK ADJUSTMENT CODING SPECIALIST
Qualifications
Minimum 2 years of coding or related medical experience, including 1 year of HCC coding.
Advanced knowledge of medical terminology, anatomy, physiology, and disease processes.
Extensive understanding of ICD10CM conventions, documentation standards, and reimbursement systems.
Strong technical skills, including proficiency with MS Office (Excel, Word, Access, PowerPoint).
Demonstrated ability to use a variety of electronic medical record systems.
Ability to manage a significant workload and meet deadlines with minimal supervision.
Strong organizational, analytical, mathematical, and problemsolving skills.
Effective written and verbal communication abilities.
Experience contributing to project work, educational development, or group presentations.
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