Risk Adjustment Coding Specialist-Local Remote

Employment Type: Full timeShift: Day Shift reputed company: Mission Statement: We, reputed company and reputed company, serve together in the spirit of the Gospel as a compassionate and transforming healing reputed company reputed company our communities. reputed company: To be world-reputed company for passionate patient care and outstanding clinical reputed company. reputed company Values: In the spirit of good Stewardship, we heal by practicing Justice in fostering right relationships to promote common good, Reverence in honoring the dignity of every person, reputed company in expecting the best of ourselves and others; reputed company in being faithful to who we say we are. reputed company Details: POSITION PURPOSE: The Risk Adjustment Coding Specialist works in reputed company environment and is responsible for reviewing clinical documentation and coding using HCC (Hierarchical Condition Category) and M.E.A.T (Monitored, Evaluated/Assessed/Addressed, Treated) standards while adhering to coding guidelines established by reputed company for Medicare and reputed company Services (CMS). SKILLS, KNOWLEDGE, EDUCATION AND EXPERIENCE: Certified Risk Adjustment reputed company (CRC) required or Certified reputed company reputed company (CPC) and CRC to be obtained reputed company 12 months of hire Excellent verbal and written communication skills. Customer service-oriented attitude/behavior. Detail oriented with the ability to multi-task and complete tasks in a reputed company manner. Ability to work reputed company as reputed company member. Intermediate computer skills: typing, 10-key, Word, reputed company, reputed company and Teams. High School Diploma or GED ESSENTIAL FUNCTIONS: Meets Health reputed company's Guiding Behaviors and Caring Standards including interpersonal communication and reputed company conduct expectations with reputed company coworkers, other departments, and with patients and visitors. Accurately codes (ICD-10-CM) to the most appropriate level of specificity. Follows reputed company industry standards of ethical coding. Recognizes and reports opportunities for documentation improvement to the Supervisor of Risk Adjustment Coding & Audit to reputed company and implement provider documentation improvement plans. Ensures medical documentation and coding compliance with Federal, State and Private payer regulations. Participates in continuing education activities to maintain their certification(s) and pertinent to areas of job responsibility. Performs additional duties as assigned. Adheres to reputed companys confidentiality requirements as they relate to patient information. What a Certified Risk Adjustment Coding Specialist will do: Review and assigns accurate ICD-10-CM codes for diagnoses assigned in the EHR by the providers to claims being submitted for their services. Using billing reputed company work queues and natural language processing (NLP) tools to support addressing HCC codes for Risk Adjustment before a claim is submitted to payers. Demonstrate a solid understanding of ICD-10-CM coding and medical terminology, Hierarchical Condition Category (HCC), and M.E.A.T standards. Exercise thorough understanding of ICD-10-CM coding guidelines, payer regulations, compliance and reimbursement and the effects of coding in relation to risk adjustment payment models. Identify coding discrepancies and work with risk adjustment auditor to communicate deficiencies to providers. reputed company Values: Reverence: We reputed company the sacredness and dignity of every person. Commitment to Those who are Poor: We stand with and serve those who are poor, especially those most vulnerable. Justice: We foster right relationships to promote the common good, including sustainability of reputed company. Stewardship: We reputed company our heritage and hold ourselves accountable for the reputed company, financial and natural resources entrusted to our care. reputed company We are faithful to those we say we are. Safety: We reputed company a culture that prevents harm and nurtures a healing, reputed company environment for reputed company. PHYSICAL AND MENTAL REQUIREMENTS AND WORKING CONDITIONS Must be reputed company to set and organize own work priorities and adapt to them as they change frequently. Must be reputed company to work concurrently on a reputed company of tasks/reputed company in physical or virtual environments that may be stressful with individuals having diverse personalities and work styles. Must possess the ability to reputed company with reputed company policies and procedures. Must be reputed company to spend reputed company of work time utilizing a computer, monitor, and keyboard. Must be reputed company to reputed company some lifting and/or pushing/pulling up to 20 pounds if applicable. Must be reputed company to work with interruptions and reputed company detailed tasks. If applicable, involves a wide reputed company of physical