What are the responsibilities and job description for the Risk Coder position at SYNERGY HEALTHCARE MSO LLC?
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:
Review medical records to accurately identify and submit risk-adjustable conditions based on available documentation.
Abstract and assign appropriate ICD-10-CM codes for Hierarchical Condition Category (HCC) capture.
Flag potential diagnoses for clinician validation and education when documentation is unclear or incomplete.
Collaborate with the clinical documentation team to ensure risk adjustment practices are consistent and compliant with regulatory standards.
Maintain productivity and accuracy according to internal policies and client expectations.
Stay updated with CMS risk adjustment guidelines and coding best practices.
Qualifications:
Minimum of 2 years of hands-on risk adjustment coding experience, preferably in a Medicare setting.
Certified Professional Coder (CPC) or Certified Risk Adjustment Coder (CRC) certification required.
Strong understanding of HCC models (CMS-HCC, HHS-HCC, etc.) and risk adjustment methodologies.
Proficiency in navigating EMRs and coding platforms.
Excellent attention to detail, time management, and communication skills.
High level of integrity and adherence to privacy and compliance standards.
Preferred Qualifications:
Experience working with remote teams.
Background in provider education or Clinical Documentation Improvement (CDI) support is a plus.
Benefits Include:
Competitive wages
Health, life, vision, and dental insurance
Short- and long-term disability coverage
401(k) plan
Up to 3 weeks of paid time off
7 paid holidays
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!
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