Risk Coder

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

📋 Description

• Acts as a specialist on ICD-10-CM coding standards, AHA Coding Clinic Guidance, and MassHealth Risk Adjustment directives.

• Conducts record reviews with a strong understanding of prevalent EHRs, particularly Epic, NextGen, Centricity, and eCW.

• Aids in the preparation and presentation of project reports and supports provider-facing communications.

• Executes internal audits in accordance with quality assurance procedures.

• Manages permissible changes to billing to ensure precision, which involves significant collaboration with FQHC billing and operations staff departments.

• Assists in organizing charts for providers prior to patient appointments.

• Engages with the provider education team regarding observed trends to enhance documentation practices.

• Leverages population health reporting tools to help identify patients and conditions that require review and improvement.

• Recognizes opportunities for enhancing FQHC risk scores.

• Performs additional responsibilities as assigned.

⛳️ Requirements

• 0-5 years of experience in risk coding.

• 0-5 years in medical billing experience within an outpatient environment, preferably in primary care, pediatrics, or behavioral health.

• Comprehensive knowledge of medical terminology, anatomy, physiology, and disease processes.

• Familiarity with electronic health record systems including Epic, NextGen, Centricity, and eCW is preferred.

• Proficiency in Medicaid and/or Medicare risk adjustment models.

• Required expertise in billing compliance.

• Self-motivated; demonstrates a high level of initiative, judgment, discretion, and decision-making to meet goals.

• Proficient in Excel.

• Works with utmost integrity and delivers precise results with meticulous attention to detail, particularly when finalizing deliverables for both internal and external stakeholders.

• Certification as a Certified Risk Coder (CRC) through AAPC is mandatory.

🏝️ Benefits

• Competitive salary.

• Comprehensive health benefits.

• Opportunities for professional development and advancement.

• Supportive work environment.