Medicare Risk Adjustment Coding Manager

Village Care•New York, NY

1d•Remote

About The Position

Join VillageCare as a Full-Time Medicare Risk Adjustment Coding Manager and enjoy the thrill of playing a vital role in healthcare's future while working from the comfort of your home. This position offers unparalleled flexibility, allowing you to balance personal and professional commitments seamlessly. Envision being part of a team that prioritizes excellence and customer-centric solutions in the ever-evolving health care landscape, all while residing in the vibrant city of New York, NY. As a key player in our organization, you will lead initiatives that directly impact patient care and financial outcomes. The compensation for this role ranges from $102,549.17 to $115,367.82 , reflecting the importance we place on your expertise and leadership. If you are a smart problem solver with a passion for integrity and high-performance culture, consider applying to be a part of our forward-thinking team. VillageCare: Our Mission VillageCare is a community-based, not-for-profit organization serving people with chronic care needs, as well as seniors and individuals in need of continuing care and managed care services. Our mission is to promote healing, better health and well-being to the fullest extent possible. Our care is offered through a comprehensive array of community and residential programs, as well as managed care. VillageCare has delivered quality health care services to individuals residing within New York City for over 45 years.

Requirements

CPC, CPMA, CRC, CCS-P, CCS, RHIA, or RHIT certification.
At least five years of experience in Medicare Risk Adjustment coding.
Familiarity with RADV audits.
Strong command of ICD-10 and CPT codes.
Experience using electronic medical record systems.
Excellent communication skills are vital for effectively collaborating within the department and with cross-functional teams.
A Bachelor's degree in Business Administration, Finance, or a relevant field, or equivalent work experience, is required.

Nice To Haves

Proficiency in HEDIS measure specifications and quality gap closure operations is highly preferred.

Responsibilities

Coordinating Risk Adjustment and Quality coding operations, emphasizing documentation integrity across both areas.
Overseeing retrospective and prospective chart review programs.
Supervising the Risk Adjustment coding staff.
Managing day-to-day vendor operations.
Acting as the operational bridge between Risk Adjustment and the HEDIS/Quality abstraction team, ensuring that all medical record interactions are utilized effectively for Hierarchical Condition Category (HCC) accuracy and closing quality gaps.
Eliminating redundant provider outreach and maximizing the clinical value of each chart interaction.
Achieving year-over-year improvements in Risk Adjustment accuracy, Risk Adjustment Factor (RAF) performance, and STARs quality measure outcomes.