Risk Adjustment Coder
Posted 2 weeks ago by 1753280308
Negotiable
Outside
Remote
USA
Summary: The Risk Adjustment Coder is responsible for coding, abstracting, and analyzing inpatient and outpatient medical records using ICD-10 for CMS risk adjustment purposes. The role requires adherence to official coding guidelines and the ability to meet productivity and accuracy standards. Coders will work remotely or from St. Louis, Missouri, and will engage in various projects as needed. A strong understanding of risk adjustment and coding specifics is essential for success in this position.
Key Responsibilities:
- Codes, abstracts and analyzes inpatient and/or outpatient medical records using ICD-10 for CMS risk adjustment purposes.
- Codes to the highest level of specificity across multiple lines of business such as Marketplace (ACA) and Medicare Advantage.
- Follows Official ICD-10 guidelines for Coding and Reporting.
- Understands the impact of ICD-10 codes on the CMS HCC risk adjustment model.
- Meets productivity and accuracy standards.
- Defends coding decisions during internal and external audits.
- Performs other duties as assigned.
- Reviews medical records and abstracts HCCs for members daily.
- Works on additional special projects as needed.
Key Skills:
- Coding and analyzing medical records using ICD-10.
- Understanding of Official ICD-10 guidelines for Coding and Reporting.
- Ability to meet productivity and accuracy standards.
- CPC or CCS certification required; CRC preferred.
- 2 years of medical coding experience with risk adjustment knowledge preferred.
- Tech-savvy with knowledge of Microsoft 365.
- Attention to detail and ability to work under pressure.
Salary (Rate): £22.50 hourly
City: Saint Louis
Country: USA
Working Arrangements: remote
IR35 Status: outside IR35
Seniority Level: undetermined
Industry: Other
job summary:
Story Behind the Need
- Codes, abstracts and analyzes inpatient and/or outpatient medical records using International Classification of Diseases, Tenth Revision (ICD-10) for CMS risk adjustment purposes.
- Codes, abstracts and analyzes inpatient and/or outpatient medical records using International Classification of Diseases, Tenth Revision (ICD-10). Always coding to the highest level of specificity.
- Code in multiple lines of business such as Marketplace (ACA) and Medicare Advantage
- Follows the Official ICD-10 guidelines for Coding and Reporting and has a complete understanding of these guidelines.
- Follows CMS risk adjustment guidelines and has a complete understanding of these guidelines.
- Understands the impact of ICD-10 codes on the CMS HCC risk adjustment model.
- Ability to meet productivity and accuracy standards
- Ability to defend coding decisions to both internal and external audits.
- Performs other duties as assigned. Work environment is positive and engaging.
location: Saint Louis, Missouri
job type: Contract
salary: $20 - 29 per hour
work hours: 8am to 5pm
education: Bachelors
responsibilities:
Typical Day in the Role
- Coders will work daily reviewing medical records abstracting HCCs for members.
- Coders will also work on additional special projects as needed dependent on business needs.
- 100% Remote
- Accuracy: 95%
- Production: 7-9 HCC's an hour
qualifications:
Candidate Requirements
- Education/Certification Required: CPC or CCS Preferred: CRC
- Licensure Required:
- Years of experience required: 2 years of medical coding experience, risk adjustment knowledge is preferred.
- Disqualifiers: Not certified.
- Additional qualities to look for: Tech savvy - Knowledge of computer basics. Comfortable utilizing Microsoft 365 (Word, Excel, Teams, Outlook)
- Ability to navigate through the ICD-10-CM codebook. Candidates who are enthusiastic and pay close attention to detail, ability to work under pressure as we pivot between multiple projects dependent on business needs.
Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.
At Randstad Digital, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact
Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad Digital offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).
This posting is open for thirty (30) days.
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