Risk Adjustment Coding Specialist - per diem - Albany, NY

Employment Type:

Part time

Shift:

Day Shift

Description:

The Risk Adjustment Coding Specialist works in a team environment and is responsible for reviewing clinical documentation and coding using HCC (Hierarchical Condition Category) and M.E.A.T (Monitored, Evaluated/Assessed/Addressed, Treated) standards while adhering to coding guidelines established by the Centers for Medicare and Medicaid Services (CMS).  

CDPHP contract specific RA Coding Specialist job primary functions:

• Working and managing specific payer populations
• Review of the patient population chronic and/or suspect condition(s) gaps and provide updates into respective systems
• HCC education and training
• Reporting weekly progress

SKILLS, KNOWLEDGE, EDUCATION AND EXPERIENCE:

• Certified Risk Adjustment Coder (CRC) required.
• Excellent verbal and written communication skills.
• Customer service-oriented attitude/behavior.
• Detail oriented with the ability to multi-task and complete tasks in a timely manner.
• Ability to work well as a team member.
• Intermediate computer skills: typing, 10-key, Word, Excel, Outlook and Teams.
• High School Diploma or GED

What a Certified Risk Adjustment Coding Specialist will do:

• Review and assigns accurate ICD-10-CM codes for diagnoses assigned in the EHR by the providers to claims being submitted for their services.  Using billing system work queues and natural language processing (NLP) tools to support addressing HCC codes for Risk Adjustment before a claim is submitted to payers.  
• Demonstrate a solid understanding of ICD-10-CM coding and medical terminology, Hierarchical Condition Category (HCC), and M.E.A.T standards.
• Exercise thorough understanding of ICD-10-CM coding guidelines, payer regulations, compliance and reimbursement and the effects of coding in relation to risk adjustment payment models.
• Identify coding discrepancies and work with risk adjustment auditor to communicate deficiencies to providers.

Pay Range: $24.60- $35.70

Pay is based on experience, skills, and education. Exempt positions under the Fair Labor Standards Act (FLSA) will be paid within the base salary equivalent of the stated hourly rates. The pay range may also vary within the stated range based on location.

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.