Job Description

Summary:  Our client is a growing risk adjustment company looking for motivated candidates with a clinical and coding background to join our team of senior coders/nurses. As a Retrospective Risk Adjustment Reviewer, you would be responsible for reviewing medical records, evaluating and assessing provider documentation, and submitting supported ICD-10 diagnosis codes according to specified guidelines. Chart review performed remotely via Electronic Health Record (EHR).

Responsibilities:

• ICD-10 Coding of Outpatient and Inpatient diagnoses
• Evaluating and assessing provider documentation
• Applying client-specific guidelines in the coding of diagnoses

Required Knowledge and Skills:

• In-depth knowledge of medical terminology, ICD-10 coding, and Risk adjustment
• Retrospective review- HCC coding
• Medical chart review experience. Preferably Epic.
• Basic concepts of human anatomy, physiology, and pathology
• Ability to work with accuracy and attention to detail
• Excellent understanding of clinical documentation requirements and coding guidelines

Preferred Qualifications: At least three of the following criteria:

• Minimum 8 years of experience in risk adjustment or medical chart review
• ICD-10/ICD-9 coding background
• Clinical Background, ie. RN, NP, PA, MD
• Certified Professional Coder (CPC)
• Certified Risk Coder (CRC)

Education: Associate’s degree (or equivalent combination of formal education and experience) required. Bachelor’s Degree preferred