Risk Adjustment Coding Specialist III
About The Position
Serves as an advanced coding resource supporting risk adjustment coding quality, documentation integrity, and operational effectiveness. Applies specialized expertise in Medicare risk adjustment methodologies, coding compliance, and documentation improvement to resolve complex coding issues and support organizational performance. Functions as a subject matter resource for coding guidance, onboarding support, and departmental initiatives. Works independently with limited supervision and is routinely relied upon to address non-routine coding issues, support process improvement efforts, and provide guidance to peers.
Requirements
- Advanced coding resource supporting risk adjustment coding quality, documentation integrity, and operational effectiveness.
- Specialized expertise in Medicare risk adjustment methodologies, coding compliance, and documentation improvement.
- Ability to resolve complex coding issues and support organizational performance.
- Subject matter expertise for coding guidance, onboarding support, and departmental initiatives.
- Ability to work independently with limited supervision.
- Ability to address non-routine coding issues.
- Ability to support process improvement efforts.
- Ability to provide guidance to peers.
Responsibilities
- Serve as a subject matter resource for risk adjustment coding practices, coding compliance requirements, and CMS validation standards.
- Analyze complex coding scenarios and documentation issues to determine appropriate coding outcomes and recommendations.
- Support onboarding and development of coding staff through coaching, training, and knowledge sharing activities.
- Research coding guidance, regulatory changes, and industry best practices and translate findings into operational recommendations.
- Evaluate coding workflows, documentation practices, and operational processes to identify improvement opportunities.
- Develop coding resources, procedures, and reference materials that support consistency and quality across the function.
- Participate in departmental projects, audits, and cross-functional initiatives supporting risk adjustment performance.
- Analyze provider coding patterns and assist in development of educational recommendations to improve coding accuracy and documentation quality.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
No Education Listed
