Risk Adjustment Coding Specialist
About The Position
Gather Health is seeking a Risk Adjustment Coding Specialist to join our growing team. This role is critical to ensuring the accuracy and completeness of diagnosis documentation and coding to support value-based care under Medicare Advantage and ACO REACH contracts. The ideal candidate has a deep understanding of HCC and CPT coding, is detail-oriented, and has strong interpersonal skills to provide feedback and education to PCPs. This role is primarily remote but may require periodic onsite meetings for one-on-one or group provider educational sessions, and team meetings as needed.
Requirements
- Two (2)+ years previous experience as a certified professional coder
- Certified Professional Coder through the American Academy of Professional Coders (AAPC) or Certified Coding Specialist through the American Health Information Management Academy (AHIMA)
- High school diploma or equivalent; AS degree in accounting, health care administration, finance, business, or related field preferred
- Able to multitask, prioritize, and manage time efficiently
- Self-motivated and self-directed; able to work without supervision
- Excellent verbal, written, and interpersonal communication skills
- Proficient computer skills, Microsoft Office Suite (Word, PowerPoint, Outlook, and Excel).
Responsibilities
- Making sure that codes are assigned correctly and sequenced appropriately as per government and insurance regulations
- Complying with medical coding guidelines and policies
- Reviewing patients’ charts and documents for verification and accuracy (retrospective, prospective and Concurrent Chart Review)
- Maintaining productivity and quality standards as set by the company
- Communicating professionally with co-workers regarding clinical and reimbursement issues
- Reporting missing or incomplete documentation while working with the providers to fix documentation errors. Following up and clarifying any information that is not clear to PCPs.
Benefits
- Health: Comprehensive medical, dental, and vision with day-one eligibility
- Protection: Company-paid Life, Short-Term, and Long-Term Disability insurance
- Retirement: 401(k) with company match and immediate vesting
- Time Off: Generous PTO that increases with tenure and 11 paid company holidays
- Wellness: Employee Assistance Program (EAP) and supplemental benefit options
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
