ASAS Health
Overview
We are seeking a Certified Risk Adjustment Coding Analyst to support accurate medical coding and ensure compliance with risk adjustment guidelines. This role plays a vital part in optimizing coding accuracy for ASAS Health while supporting revenue integrity and regulatory compliance. The ideal candidate will have a strong background in medical coding, risk adjustment methodologies, and data validation processes.
ESSENTIAL FUNCTIONS
Medical Coding:
Accurately assign diagnostic codes (ICD-10-CM) from clinical documentation following risk adjustment guidelines (Medicare Advantage, Medicaid, ACA, etc.).
Compliance & Accuracy:
Ensure coding adheres to official coding guidelines, payer policies, and regulatory standards.
Chart Reviews:
Conduct audits of medical records to verify code accuracy, identify discrepancies, and support compliance efforts.
Provider & Team Support:
Collaborate with physicians, billers, coders, and clinician teams to enhance documentation and educate on risk adjustment best practices.
Data Analysis:
Monitor coding trends, conduct data validation, and generate reports to assess risk scores and financial impact.
Continuous Learning:
Stay up to date with regulatory changes, coding guidelines, and industry updates affecting risk adjustment coding. Always maintain active coding certification.
Education and Experience
Minimum of three years’ experience in risk adjustment coding. Preferred five years of experience in health care coding.
Certified Professional Coder (CPC), Certified Risk Adjustment Coder (CRC), or equivalent certification required.
Knowledge, Skills, and Abilities
Strong knowledge of ICD-10-CM coding guidelines, HCC coding, and CMS regulations.
Experience conducting audits and validations for risk adjustment accuracy.
Excellent analytical skills with attention to detail in medical documentation.
Strong communication and collaboration skills for provider education.
Ability to handle multiple tasks with a high level of accuracy.
Detail-oriented and organized.
Strong work ethic.
Experience with Medicare Advantage, Medicaid, or Affordable Care Act risk adjustment programs.
Familiarity with EHR systems like Elation and Athena, and AI applications like Ambiance.
Ability to interpret regulatory changes and apply them to coding practices.
Seniority level
Associate
Employment type
Full-time
Job function
Analyst
Industries
Hospitals and Health Care
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ESSENTIAL FUNCTIONS
Medical Coding:
Accurately assign diagnostic codes (ICD-10-CM) from clinical documentation following risk adjustment guidelines (Medicare Advantage, Medicaid, ACA, etc.).
Compliance & Accuracy:
Ensure coding adheres to official coding guidelines, payer policies, and regulatory standards.
Chart Reviews:
Conduct audits of medical records to verify code accuracy, identify discrepancies, and support compliance efforts.
Provider & Team Support:
Collaborate with physicians, billers, coders, and clinician teams to enhance documentation and educate on risk adjustment best practices.
Data Analysis:
Monitor coding trends, conduct data validation, and generate reports to assess risk scores and financial impact.
Continuous Learning:
Stay up to date with regulatory changes, coding guidelines, and industry updates affecting risk adjustment coding. Always maintain active coding certification.
Education and Experience
Minimum of three years’ experience in risk adjustment coding. Preferred five years of experience in health care coding.
Certified Professional Coder (CPC), Certified Risk Adjustment Coder (CRC), or equivalent certification required.
Knowledge, Skills, and Abilities
Strong knowledge of ICD-10-CM coding guidelines, HCC coding, and CMS regulations.
Experience conducting audits and validations for risk adjustment accuracy.
Excellent analytical skills with attention to detail in medical documentation.
Strong communication and collaboration skills for provider education.
Ability to handle multiple tasks with a high level of accuracy.
Detail-oriented and organized.
Strong work ethic.
Experience with Medicare Advantage, Medicaid, or Affordable Care Act risk adjustment programs.
Familiarity with EHR systems like Elation and Athena, and AI applications like Ambiance.
Ability to interpret regulatory changes and apply them to coding practices.
Seniority level
Associate
Employment type
Full-time
Job function
Analyst
Industries
Hospitals and Health Care
#J-18808-Ljbffr