Risk Adjustment Coder

Village Care•New York, NY

1d•Remote

About The Position

Join VillageCare as a Full Time Risk Adjustment Coder and embrace the opportunity to work remotely while making a significant impact in the Health Care sector. This role offers the flexibility of a work-from-home environment, allowing you to balance your professional and personal commitments without the daily commute. You'll be part of a dynamic team that thrives on innovation, problem-solving, and a customer-centric approach, all while contributing to the excellence and integrity that VillageCare stands for. With a competitive salary up to $77,506.87 - $87,195.23, this is not just a job but a chance to build your career in a forward-thinking organization dedicated to healthcare improvement. As a team member you'll be able to enjoy benefits such as PTO package, 10 Paid Holidays, Personal and Sick time, Medical/Dental/Vision, HRA/FSA, Education Reimbursement, Retirement Savings 403(b), Life and Disability, Commuter Benefits, Paid Family Leave, and Additional Employee Discounts. Seize the opportunity to grow in a high-performance culture that values your contributions. Apply today and help shape a healthier future!

Requirements

Robust understanding of clinical terminology, disease processes, anatomy and physiology, as well as pharmacology.
Strong foundation in claims processing procedures, state and federal regulations, and Medicare Coordination of Benefits applications.
At least three recent years of experience in HCC/Risk Adjustment and/or inpatient coding.
Exceptional attention to detail.
Basic computer skills.
Ability to maintain a productive home office environment with high-speed internet.
Must reside in NY, NJ or CT.
5 recent years of HCC / Risk Adjustment and/or inpatient coding are required.
Certified through AAPC or AHIMA(CPC, CRC, RHIT, or RHIA).
CPC, CCS, RHIT or RHIA and CRC are required.
Have high speed internet at their house and a distraction free home office.
Must be detail oriented and have basic computer skills.
Strong knowledge of claims processing procedures and systems.
State, Federal and Medicare Regulations and Coordination of Benefits applications required.

Responsibilities

Perform critical code abstraction of medical records, ensuring accurate assignment of ICD-9-CM, ICD-10-CM, CPT, and HCPCS codes supported by clinical documentation.
Conduct a comprehensive review of medical records, validating that documentation meets CMS requirements, including provider signatures and relevant dates.
Identify improvement opportunities in documentation and coding processes.
Participate in quality initiatives that enhance overall outcomes.
Maintain current knowledge of coding standards and regulations.
Support the Medicare Risk Adjustment team in educating providers on compliance and consistency.
Report findings from audits.
Assist in analysis.
Maintain a minimum accuracy of 95% on coding quality audits while meeting productivity requirements.