Clinical Risk Adjustment Lead

Job Description

• Assisting Managers with clinical pends • Assisting with over-read feedback • Assigning manual assignments • Assisting with individual data entry production (MRR or OR1) • Reviewing reports daily for QA scores during the season(s) (abstractors, coders, HPs) • Ensure collaboration among cross functional teams for the roll out of product releases • Additional duties as necessary to meet the obligations to our clients

Qualifications

• Current Coding Certification (CPC, CPC-P, CPC-H, CPC-I, CRC, CCS, RHIT, RHIA etc.) through AAPC and/or AHIMA • Minimum of 5 years coding experience with specific knowledge of Medicare and Commercial Risk Adjustment such as Hierarchical Condition category (HCC) • Additional experience in facility (OPPS/IPPS) coding experience is preferred • Additional experience in Health Plan Risk Adjustment Data Validation Audit (RADV) experience is preferred • Excellent verbal and written communication skills, including the ability to effectively communicate with internal and external customers

Benefits

• Competitive salary • Medical, dental, and vision benefits • 401k Matching • Generous PTO & holidays