What are the responsibilities and job description for the Risk Adjustment Coding Specialist position at AdventHealth PHSO Resources?
Risk Adjustment Coding Specialist – AdventHealth PHSO Resources
All the benefits and perks you need for you and your family:
- Benefits from Day One
- Paid Days Off from Day One
- Career Development
- Whole Person Wellbeing Resources
- Mental Health Resources and Support
Our promise to you:
Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.
Schedule: Full Time
Shift : Mon-Friday 8am - 5pm
Location: Virtual
The role you’ll contribute:
The Medicare Risk Adjustment Coding Specialist coordinates and supports retrospective and concurrent chart reviews in addition to education and chart retrieval for Health Plan audits and reports. Uses knowledge of Hierarchical Condition Categories (HCC) coding to translate, input, extract and validate medical record data.
The value you’ll bring to the team:
- Review and assess documentation and accurately translates chronic conditions into the appropriate diagnosis code from inpatient and outpatient medical records
- Extracts data for Health Plan reports
- Inputs data collected from HCC programs
- Coordinates audits of Provider coding data
- Responsible for scheduling of audits
- Sends Provider the list for chart reviews and provides follow-up communication
- Assists in obtaining medical records from Providers to support audits requested by Health Plans
- Assists in coordinating Physician and staff training sessions
The expertise and experiences you’ll need to succeed :
Minimum qualifications:
- 3 healthcare experience
- 3 experience in HCC coding
- CPC (Certified Professional Coder)
Preferred qualifications:
- Prior risk adjustment and medical record review.
- Experience with Medicare risk adjustment, Hierarchical Condition Categories (HCC), coding, billing, auditing and various healthcare payers.
This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay range for this position. Individual compensation is determined based on skills, experience and other relevant factors within this pay range. The minimums and maximums for each position may vary based on geographical location.
Category: Health Information Management
Organization: AdventHealth PHSO Resources
Schedule: Full-time
Shift: 1 - Day
Req ID: 25010555
We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.
