Certified Risk Adjustment Coding Specialist

Trinity Health•Livonia, MI

2d•$24 - $36•Remote

About The Position

The Certified Risk Adjustment Coding Specialist assigns ICD and CPT codes to participant health information for data retrieval, analysis, and claims processing. The role also abstracts and validates medical-record data and provides education on documentation that supports HCCs. This is a fully remote, full-time position. Regular work hours are either 8:00 a.m. to 4:30 p.m. or 7:00 a.m. to 3:30 p.m. Eastern Time. Onsite training is required during the second week of employment and takes place in Livonia, Michigan, for one week; expenses are paid. The position may also require occasional travel to the Livonia home office or other supported locations. Trinity Health PACE provides comprehensive services through an interdisciplinary team to help seniors remain independent at home. The organization is guided by reverence, commitment, safety, justice, stewardship, and integrity.

Requirements

High school diploma or equivalent.
One of the following certifications: Certified Outpatient Coder, Certified Coding Specialist, Certified Professional Coder through AAPC, Registered Health Information Technologist through AHIMA, or Registered Health Information Administrator through AHIMA.
Must hold or be obtaining the Certified Risk Adjustment Coder certification through AAPC; if not obtaining it, must earn it within one year of hire.
Two years of experience in a risk adjustment coding environment.
Demonstrated ability to verify and validate HCCs.
Demonstrated knowledge and ability to educate and guide providers.
Knowledge of medical terminology, human anatomy and physiology, and disease processes.
Strong communication, problem-solving, customer service, critical-thinking, and organizational skills.
Comprehensive proficiency with Microsoft products, including Word, Excel, and PowerPoint, and ability to use other software as needed for essential job functions.
Ability to prioritize workload.
Ability to travel occasionally to the Livonia, Michigan home office or other supported locations.
Ability to attend required in-person training in Livonia, Michigan during the second week of employment.

Nice To Haves

Two years of completed college coursework is preferred.

Responsibilities

Evaluate medical records to identify diagnoses and procedures, then accurately assign and sequence ICD and CPT codes.
Abstract and validate information and seek additional validating information as needed.
Conduct documentation spot checks and respond to audit feedback.
Ensure client-care documentation is timely and accurate for billing.
Monitor and inform the manager about records that are not completed on time.
Monitor, investigate, and take appropriate action on records that are not coded, billed, or that have been rejected.
Stay current on coding guidelines and reimbursement requirements.
Maintain participant confidentiality and comply with HIPAA guidelines.
Support site staff compliance with federal and state requirements and accreditation regulations through record review, case conferencing, and communication.
Provide education and guidance to providers on documentation.