Risk Adjustment Specialist
Viva Health•Birmingham, AL
•Onsite
About The Position
The Risk Adjustment Specialist ensures all ICD-10 codes are documented for the assignment of valid and accurate HCCs for each record reviewed for submission to the Centers for Medicare & Medicaid Services (CMS). Other responsibilities include working suspect reports to identify unreported diagnosis codes and conducting chart audits on in-house records from other departments. This position will assist the Manager of Risk Adjustment with other projects as needed.
Requirements
- High School Diploma or GED
- At least 3-5 years' experience with coding
- Certified Coder (AHIMA or AAPC credentials)
- Read and interpret handwritten and typewritten material
- Excellent oral and written communications skills
- Ability to work under pressure to meet deadlines with minimal supervision
- Basic computer skills
Nice To Haves
- 2 or more years of college
- Experience with hospital coding
Responsibilities
- Maintain thorough understanding of the risk-adjusted payment methodology; what can be submitted by the plan and how/when submission impacts CMS payments.
- Demonstrate knowledge of ICD10 coding guidelines, medical terminology, disease processes, and pharmacology.
- Interpret and demonstrate analytical and problem-solving ability in reviewing medical record documentation to accurately assign ICD10 codes.
- Conduct chart reviews to identify all appropriate diagnoses based on CMS-HCCs and specific HEDIS measures.
Benefits
- Comprehensive Health, Vision, and Dental Coverage
- 401(k) Savings Plan with company match and immediate vesting
- Paid Time Off (PTO)
- 9 Paid Holidays annually plus a Floating Holiday to use as you choose
- Tuition Assistance
- Flexible Spending Accounts
- Healthcare Reimbursement Account
- Paid Parental Leave
- Community Service Time Off
- Life Insurance and Disability Coverage
- Employee Wellness Program
- Training and Development Programs to develop new skills and reach career goals
- Employee Assistance Program
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
