Job Description:Our client, a nonprofit healthcare company, is looking to bring on three CRC and CPC certified Risk Adjustment Auditors for a five-month contract on a 100% remote basis. While this role is remote, candidates must reside in one of the following states: Oregon, Washington, Idaho or Utah. The risk adjustment auditor II performs retrospective and prospective chart reviews utilizing various types of records to ensure accurate risk adjustment reporting. The role Identifies trends in provider coding and documentation, working closely withprovider education consultants to develop intervention strategies.Responsibilities:
- Performretrospective and prospective chart reviews to ensure accurate risk adjustment reporting.
- Verifyand ensurethe accuracy, completeness, specificity and appropriateness of provider-reported diagnosis codes based on medical record documentation.
- Reviewmedical record information to identify complete and accurate diagnosis code capture based on CMS HCC categories.
- Identifytrends in provider coding and documentation and partners with consultants to develop intervention strategies.
- Supports and actively participatein process and quality improvement initiatives.
- Maintainknowledge of relevant regulatory mandates and ensureactivities are in compliance with requirements.
- Consistently meet departmental performance and attendance requirements.
- Serveas a mentor to risk adjustment auditor I staff.
- Assistwith special projects such as risk mitigation reviews.
- Serveas subject matter resource regarding the risk adjustment process and diagnosis coding for risk adjustment.
- Monitorand interpretregulatory changes that may impact administration of the risk adjustment program.
- Assistwith implementation activities as a result of regulatory changes to the program.
Requirements:
- Associate degree in healthcare or related field
- 3+ years of experience in clinical coding or auditing or equivalent combination of education and experience
- Certified risk adjustment coder
- Certified professional coder
- Demonstrated ability to perform accurate and complete chart reviews for risk adjustment
- Knowledge of and adherence to official ICD-9-CM/ICD-10 coding guidelines
- Demonstrated analytical ability to identify problems, develop solutions and implement actions in a timely manner
- Demonstrated ability to identify and communicate trends in provider coding and documentation
- Demonstrated proficiency withPC skills and familiarity with corporate software, such as Word, Excel and Outlook
- Effective verbal and written communication skills
- Knowledge of health systems operations, including an understanding of reimbursement methodologies and coding conventions for governmental and commercial products
- Advanced knowledge and understanding of risk adjustment, coding and documentation requirements
- Demonstrated ability to provide proactive and creative solutions to business problems
Contact:Karrie Ruch...@jacobsononline.comRefer a Colleague:Do you know someone who would be interested in this project? Submit your referral directly by emailing the Jacobson contact listed above or submitting them through this form. If your referral is hired for a contract assignment and meets all other eligibility criteria, you will receive a referral bonus!