- HybridDepartment: Quality
- Risk AdjustmentAbout the Role:We are currently seeking a highly motivated Risk Adjustment Coding Specialist.
- Risk Adjustment and enable us to continue to scale in the healthcare industry.
- Certified Risk Adjustment Coder (CRC) & Certified Coding Specialist (CCS-P), CCS, CPCMinimum of twoyears experience in medical coding and billing for Medicare ACO, Medicare AdvantageReliable transportation/Valid Drivers License/Must be able to travel at least 75% of work timePC skills and experience using Microsoft applications such as Word, Excel, and OutlookExcellent presentation, verbal and written communication skills, and ability to collaborateMust possess the ability to educate and train provider office staff membersYou're great for this role if:Have knowledge of Risk Adjustment and Hierarchical Condition Categories (HCC) for Medicare ACO and Medicare Advantage.
- Fridays between 8:00 AM 4:30 PM.
Risk Adjustment Coding Specialist - Alhambra, United States - Astrana Health
Description
Job Title:
Risk Adjustment Coding Specialist
What You'll Do:
Review provider documentation of diagnostic data from medical record to verify that all Medicare ACO, Medicare Advantage and Commercial risk adjustment documentation requirements are met, and to deliver education to providers on either an individual basis or in a group forum, as appropriate for all IPAs managed by the companyReview medical record information on both a retroactive and prospective basis to identify, assess, monitor, and document claims and encounter coding information as it pertains toHierarchical Condition Categories (HCC)
Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10- CM codes are accurately assigned and supported by clinical documentation to ensure adherence with CMS Risk Adjustment guidelinesInteracts with physicians regarding coding, billing, documentation policies, procedures, and conflicting/ambiguous or non-specific documentationPrepare and/or perform auditing analysis and provide feedback on noncompliance issues detected through auditingQualifications:
Required Certification/Licensure: Must possess and maintain AAPC or AHIMA certification
Who We AreAstrana Health (ASDAQ:
ASTH) is a physician-centric, technology-powered healthcare management company.
We are building and operating a novel, integrated, value-based healthcare delivery platform to empower our physicians to provide the highest quality of end-to-end care for their patients in a cost-effective manner.
Our mission is to combine our clinical experience, best-in-class delivery network, and technological expertise in order to improve patient outcomes, increase access to healthcare, and make the US healthcare system more efficient.
Our platform currently empowers over 12,000 physicians to provide care for over 1.3 million patients nationwide.Our rapid growth and unique position at the intersection of all major healthcare stakeholders (payer, provider, and patient) gives us an unparalleled opportunity to combine clinical and technological expertise in order to improve patient outcomes, increase access to quality healthcare, and reduce the waste in the US healthcare system.
Our Values:
Put Patients FirstEmpower Entrepreneurial Provider and Care TeamsOperate with Integrity & ExcellenceBe InnovativeWork As One TeamEnvironmental Job Requirements and
Working Conditions:
Our organization follows a hybrid work structure where the expectation is to work both in office and at home on a weekly basis.
The main office is located in Alhambra.This position will require frequent traveling to provider offices. Must be available to travel 75% of work time. Offices are located in Alhambra, San Gabriel Area and Los Angeles areas.
The shift will typically be on Monday
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer.
We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.
All employment is decided on the basis of qualifications, merit, and business need.If you require assistance in applying for open positions due to a disability, please email us at to request an accommodation.
Additional Information:
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.