What are the responsibilities and job description for the Risk Coder position at Coastal Health?
Job Details
Description
Job Opportunity: Medicare Risk Adjustment Coder at Coastal Health
Coastal Health is looking for an experienced Medicare Risk Adjustment Coder to join our team. In this role, you will play a crucial part in conducting detailed documentation reviews and identifying potential diagnoses for clinician validation. The ideal candidate is meticulous, well-versed in ICD-10-CM coding for risk adjustment, and committed to ensuring accurate clinical documentation to enhance patient care and organizational performance.
Key Responsibilities:
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Review medical records to accurately identify and submit risk-adjustable conditions based on available documentation.
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Abstract and assign appropriate ICD-10-CM codes for Hierarchical Condition Category (HCC) capture.
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Flag potential diagnoses for clinician validation and education when documentation is unclear or incomplete.
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Collaborate with the clinical documentation team to ensure risk adjustment practices are consistent and compliant with regulatory standards.
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Maintain productivity and accuracy according to internal policies and client expectations.
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Stay updated with CMS risk adjustment guidelines and coding best practices.
Qualifications:
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Minimum of 2 years of hands-on risk adjustment coding experience, preferably in a Medicare setting.
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Certified Professional Coder (CPC) or Certified Risk Adjustment Coder (CRC) certification required.
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Strong understanding of HCC models (CMS-HCC, HHS-HCC, etc.) and risk adjustment methodologies.
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Proficiency in navigating EMRs and coding platforms.
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Excellent attention to detail, time management, and communication skills.
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High level of integrity and adherence to privacy and compliance standards.
Preferred Qualifications:
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Experience working with remote teams.
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Background in provider education or Clinical Documentation Improvement (CDI) support is a plus.
Benefits Include:
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Competitive wages
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Health, life, vision, and dental insurance
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Short- and long-term disability coverage
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401(k) plan
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Up to 3 weeks of paid time off
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7 paid holidays
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A supportive environment that promotes career growth and personal development with opportunities for advancement within the company.
If you're passionate about making a significant impact in healthcare by supporting accurate coding practices and improving clinical documentation, we encourage you to apply today!
Qualifications
EDUCATION: High School diploma or equivalent required. Bachelors degree in related field preferred; and/or relevant equivalent and relevant work experience preferred.
MINIMUM EXPERIENCE REQUIRED: Three to five (3-5) years of general medical chart auditing experience. 1 years experience with quality auditing/improvement activities required (3 preferred), 2 years' experience using an electronic health record (EHR) software system required -Athena
MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW: N/A
