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Trinity Health PACE

Certified Risk Adjustment Coding Specialist

Trinity Health PACE, Livonia, Michigan, us, 48153

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Certified Risk Adjustment Coding Specialist

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Trinity Health PACE . This is a full‑time remote position with onsite training in Livonia, MI. Work hours: 8:00‑4:30 or 7:00‑3:30 Eastern. Training is required for the second week of employment and will be paid.

Position Purpose The primary purpose of this position is to assign ICD/CPT codes to participant health information for data retrieval, analysis, and claims processing. Duties also include abstracting and validating data from medical records and providing education on documentation to support HCCs. This fully remote position requires onsite training during the second week.

What You Will Do

Evaluate medical records, identify diagnoses and procedures, and accurately assign and sequence ICD and CPT codes. Abstract and validate information.

Conduct documentation spot checks and respond to audit feedback.

Ensure timely, accurate client care documentation for billing.

Monitor and inform manager of records that are not completed in a timely manner. Investigate and take appropriate action for records that are not coded, billed, or rejected.

Stay updated on coding guidelines and reimbursement requirements.

Maintain participant confidentiality and comply with HIPAA guidelines.

Assure site staff compliance with federal, state, and accreditation regulations through record review, case conferencing, and communication.

Minimum Qualifications

High school diploma or equivalent required.

2 years of completed college coursework preferred.

Must have one of the following certifications: Certified Outpatient Coder, Certified Coding Specialist, Certified Professional Coder through AAPC, or Registered Health Information Technologist or Registered Health Information Administrator through AHIMA.

Must be certified or obtaining certification for Certified Risk Adjustment Coder through AAPC. If not obtaining, must obtain within one year if hired.

Two‑years of experience in a risk adjustment coding environment required.

Demonstrated ability to verify and validate HCCs.

Demonstrated knowledge of medical terminology, human anatomy and physiology, and disease processes.

Strong communication, problem‑solving, customer service, critical thinking, and organizational skills.

Comprehensive proficiency with Microsoft Office (Word, Excel, PowerPoint). Ability to use other software as required.

Ability to prioritize workload.

Position may require occasional travel to Livonia, MI or other supported locations.

Position Highlights And Benefits

Comprehensive benefits including 1st day medical coverage, dental, vision, paid time off, 403(b), and educational assistance.

Access to daily pay and employee referral incentives.

Supportive environment with a patient‑centered focus.

Opportunities for professional development.

Trinity Health PACE Trinity Health PACE provides high‑quality care to seniors in the communities we serve. Our interdisciplinary team offers comprehensive services, allowing seniors to remain independent at home. We are guided by core values of reverence, commitment, safety, justice, stewardship, and integrity.

Our Commitment Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person‑centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

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