Risk Adjustment Coding Reviewer

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

📋 Description

• Perform both prospective and concurrent chart evaluations to ensure that documentation accurately reflects ICD-10 risk adjustment coding and compliance.

• Examine clinical documentation and confirm supported diagnoses.

• Operate within Cerner, NextGen, and various other risk adjustment systems.

• Engage with providers through compliant processes for documentation clarification.

• Provide education to providers and practice partners regarding risk adjustment principles, coding precision, and best practices for documentation.

• Analyze provider coding patterns utilizing data and chart reviews.

• Develop and implement education for providers and staff to improve performance in low-scoring areas.

• Aid in the preparation and delivery of educational and training materials.

• Organize and oversee training and development for providers and office personnel.

• Offer technical training in coding, risk adjustment, documentation, and billing operations.

• Gather data and propose solutions for trends in provider coding.

• Uphold a 96% accuracy rate in quality audits.

• Support research and analysis related to compliance, coding, and improper documentation.

• Ensure confidentiality in accordance with HIPAA privacy policies.

• Stay informed about coding guidelines and pertinent federal regulations.

⛳️ Requirements

• Applicants must reside in the state of AZ.

• Bachelor's degree in healthcare administration or a related field, or equivalent experience.

• Active RHIA, RHIT, or CCS credential from AHIMA, or a CPC credential with active status from AAPC.

• Minimum of four years of experience in risk adjustment.

• Familiarity with medical terminology, anatomy and physiology, and disease pathology.

• Understanding of ICD-10-CM Coding Guidelines and medical record documentation standards.

• Awareness of Medical Staff Rules and Regulations as applicable.

• Strong interpersonal and instructional abilities.

• Superior written, verbal, and customer service skills.

• Capability to perform educational needs assessments and teach effectively across varying comprehension levels.

• Proficient in commonly used office and presentation software.

• Advanced knowledge and expertise in computer healthcare applications and hardware.

🏝️ Benefits

• Options for remote work.

• Opportunities for professional development.

• Wellness benefits available.

• Continued education support.

• Promotion of work-life balance.

• Initiatives for employee engagement.