Certified Risk Adjustment Coder
Habitat Health
Risk Adjustment Consultant
Intus Care
full-time
Posted on:
Origin: • 🇺🇸 United States
Visit company websiteSalary
💰 $70,000 - $90,000 per year
Job Level
Mid-LevelSenior
About the role
- Conduct detailed reviews of medical records to validate diagnosis coding using ICD-10-CM Official Guidelines, AHA Coding Clinic, and internal IRIS Coding Guidelines.
- Complete Pre-Encounter Preparation (PEP) and concurrent coding workflows.
- Monitor analytics dashboards to identify coding gaps and provide data-driven education.
- Ensure compliance with CMS guidelines and RADV audit standards.
- Serve as the primary point of contact for assigned PACE clients.
- Collaborate with providers to improve documentation practices and coding accuracy.
- Deliver training sessions and feedback loops to clinical teams on documentation improvement.
- Conduct monthly metric reviews and educational sessions with clients.
- Lead live onsite training sessions during go-live phases and onboarding events.
- Host virtual training sessions, biweekly virtual office hours, and record sessions for asynchronous access.
- Develop and execute customized onboarding plans and coordinate implementation timelines.
- Suggest system upgrades and workflow enhancements based on client feedback.
- Support submission of accurate data to CMS and participate in internal audits and quality assurance reviews.
- Maintain a coding accuracy score of 95% or higher.
Requirements
- Required Certifications: CPC, CCS, RHIT, and CRC (Certified Risk Adjustment Coder).
- Minimum 5 years in medical coding with a focus on risk adjustment.
- High School diploma required; Associate’s or Bachelor’s degree preferred.
- Strong understanding of CMS risk adjustment models and HCC coding.
- Proficiency in EMR systems and natural language processing tools.
- Excellent communication and analytical skills.
- Ability to work independently and remotely.
- Confident in presenting trainings both in-person and virtually.
- Experience working with PACE programs or senior care populations (preferred).
- Familiarity with IntusCare’s IRIS platform and consulting workflows (preferred).
- Background in clinical documentation improvement and interdisciplinary collaboration (preferred).
- This position is not eligible for sponsorship.
