Risk Adjustment Coordinator, Remote, Baptist Health Integrated Care, FT, 08A-4:30P
About The Position
The Risk coding Regional Auditor must support the Director of risk coding along with other team professionals working to provide pre and post visit review analysis for provider practices while providing risk coding education to healthcare providers to improve practice risk scores. He or she must relate in a professional manner to co-workers, hospital administrators, physicians, Medicare beneficiaries, and others to represent the department and the health system while working closely with other departments to achieve favorable outcomes. This position is responsible for chart review and up-coding workflows. The position will also require coordination of projects to ensure the success of the goals within the CIN organization. Supports the mission, vision, values and strategic goals of Baptist South Florida. Estimated pay range for this position is $25.37 - $32.22 / hour depending on experience.
Requirements
- High School, Cert, GED, Trn, Exper.
- AAPC Certified Risk Adjustment Coder.
- AAPC Certified Professional Coder.
- AAPC Certified Professional Medical Auditor.
- Certified Professional Coder and/ or Certified Risk Adjustment Coder (CRC).
- CPMA certification must be obtained within 1 year of Hire.
- Required completion of an accredited certified coding specialist program.
- 2+ years of clinic or hospital experience and/ or managed care experience.
- 1+ years of experience in Risk Adjustment and HEDIS/Stars.
- Ability to interpret, analyze and abstract data/documentation.
- Comprehensive Knowledge of ICD-10-CM codes, Category II codes, COA measures, CMS documentation requirements, state and federal regulations including compliance and reimbursement and the impact of diagnosis coding on risk adjustment payment models.
- Ability to identify HCC improvement opportunities and educate clinical providers on proper clinical documentation, compliance, and coding guidelines.
- Intermediate level of proficiency in MS Office – Excel, PowerPoint, and Word.
- Ability to defend coding decisions to both internal and external audits.
- Strong organizational skills in multiple settings, as well as the ability to exercise judgement and initiative.
- Ability to work in a continuously changing environment.
- 5 Years minimum required experience.
Nice To Haves
- Bachelors of Science degree preferred.
Responsibilities
- Support the Director of risk coding and other team professionals.
- Provide pre and post visit review analysis for provider practices.
- Provide risk coding education to healthcare providers to improve practice risk scores.
- Relate in a professional manner to co-workers, hospital administrators, physicians, Medicare beneficiaries, and others to represent the department and the health system.
- Work closely with other departments to achieve favorable outcomes.
- Responsible for chart review and up-coding workflows.
- Coordinate projects to ensure the success of the goals within the CIN organization.
- Support the mission, vision, values and strategic goals of Baptist South Florida.
Benefits
- Career growth and development opportunities, with clear pathways and ongoing support
- Comprehensive health and wellness resources that go beyond traditional benefits
- A wellness program that can help employees eliminate their medical plan deductible, reducing out-of-pocket healthcare costs
- Tuition reimbursement to support continued learning and advancement
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
