Position Summary
Level II Risk Adjustment Coding Specialist (Intermediate). This role includes all Level I responsibilities plus additional coding, auditing, and analytics responsibilities.
Responsibilities
- Abstract and assign ICD-10-CM diagnosis codes supported in encounter documentation, working independently with minimal oversight.
- Conduct retrospective audits of medical records to validate diagnosis coding accuracy, completeness, and claim submission quality.
- Review provider actions within the Value-Based Alert Tool (VBAT) to identify outliers and improvement opportunities.
- Analyze Medicare Risk Adjustment (MRA) data to identify coding or documentation patterns and assist with interventions at the provider or regional level.
- Keep leadership informed of project activities through written and oral updates and proactively identify project risks.
- Consistently meet or exceed accuracy and productivity benchmarks.
- May be assigned additional projects or a higher workload than a Level I specialist.
Requirements & Qualifications
Qualifications
- Minimum 2 years of coding or related medical experience, including 1 year of HCC coding.
- Advanced knowledge of medical terminology, anatomy, physiology, and disease processes.
- Strong understanding of ICD-10-CM conventions, documentation standards, and reimbursement systems.
- Proficiency with MS Office, including Excel, Word, Access, and PowerPoint.
- Experience using a variety of electronic medical record systems.
- Ability to manage a significant workload and meet deadlines with minimal supervision.
- Strong organizational, analytical, mathematical, and problem-solving skills.
- Effective written and verbal communication skills.
- Experience contributing to project work, educational development, or group presentations.
Location
Florida, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
1 month ago