Senior Risk Adjustment Medical Coder – CRC Remote

HealthPartners is hiring a Risk Adjustment Coding Analyst Senior. This position is responsible for diagnosis coding review and vendor coding quality assurance; working to ensure that plan performance and plan revenue is based on an accurate representation of our population’s care needs and risks. ACCOUNTABILITIES: - Performs retrospective chart review for diagnosis coding accuracy. - Identifies, analyzes, and reports coding error trends to inform risk adjustment analytics and deliver provider education. - Reviews vendor coding and provide recurring feedback and education to vendor team. - Participates in internal and CMS-mandated risk adjustment data validation review. - Identifies, documents, and messages process improvements, clinical documentation improvements and/or other educational opportunities. - Develops and performs training and educational seminars to physicians and advanced practice providers on risk adjustment topics. - Increases collaborative efforts between HealthPartners Health Plan and HealthPartners Medical Group as it relates to optimization of diagnosis coding. - Analyzes and organizes complex information for effective reporting to leadership. - Conducts daily work consistent with HealthPartners core values and comply with all federal and state regulations. - Maintains confidentiality of protected health information. - Increases organizational efficiency in daily operations. - Responsible for other duties as assigned. REQUIRED QUALIFICATIONS: - High School Diploma or GED or Associate’s degree in a related field - One of the following credentials required: RHIA, RHIT, CPC, CCS, CCS-P - Certified Risk Adjustment Coder (CRC) credential - Minimum of five years experience with diagnosis coding review as a certified coder - Demonstrated working knowledge of the revenue cycle process, claims processing, retrospective chart review process, compliance and federal/state regulations, CPT, ICD-9, and ICD-10 coding - Identify issues and formulate solutions relating to retrospective chart review process improvement initiatives - Understand and communicate clinical documentation requirements for correct coding and to ensure integrity of the medical record - Skill and experience in effectively collaborating with team members & others using oral, written and interpersonal communications - PC skills in Microsoft Word and Excel - Organize and prioritize multiple assignments - Ability to deal with change and ambiguity - Able to work, both, as a team member or independently PREFERRED QUALIFICATIONS: - Four year college degree - Experience working with Epic Originally posted on Himalayas