Risk Adjustment Coder II

This is a fully remote position, open to applicants in South Carolina.

📋 Description

• Performs a prospective review to extract Hierarchical Condition Categories (HCC) codes for reporting in the calendar year.

• Engages with providers (through Epic and face-to-face) regarding any pending HCC capture opportunities.

• Executes retrospective reviews to verify that documentation justifies the reporting of the Hierarchical Condition Category code prior to submission to payors.

• Carries out prospective chart reviews to pinpoint HCC opportunities.

• Conducts retrospective chart evaluations to ensure documentation supports reporting.

• Leverages payor-specific software to aid in capturing HCCs.

• Discusses HCC improvement opportunities with providers.

• Recognizes potential suspect conditions that may validate HCC reporting.

• Engages in educational offerings.

• Attends monthly meetings.

• Executes additional duties as assigned.

⛳️ Requirements

• Education - High School diploma or equivalent, or a post-high school diploma / highest degree attained.

• Associate degree is preferred.

• A minimum of five (5) years of professional fee coding experience.

• Certified Professional Coder (CPC) certification.

• Certified Risk Adjustment Coder (CRC) certification.

• Familiarity with office equipment, including fax and copier.

• Proficient in computer skills, encompassing word processing, spreadsheets, and databases.

• Competent data entry skills.

• Strong mathematical abilities.

🏝️ Benefits

• Inspire health.

• Serve with compassion.

• Be the difference.