Certified Risk Adjustment Coder

Job Responsibilities Demonstrates knowledge of coding and documentation standards as well as CMS risk adjustment guidelines and hierarchical condition categories (HCCs). Reviews medical records to ensure all diagnosis codes are documented for valid and accurate HCC assignment for each episode of care. Regularly reviews Epic HCC and payor CSI (Clinically Suspect Conditions) reports. Queries and provides feedback and education to physicians to improve documentation accuracy and risk adjustment coding. Demonstrates understanding of risk adjustment payment models. Uses clinical reasoning and critical thinking to assess the financial impact of a query and prioritize efforts efficiently. Completes patient medical chart review within 24‑48 hours of visit completion. Maintains active coding credentials and completes required annual continued education hours. Observes work hours and provides proper notice regarding absences and tardiness. Maintains positive relationships with physician practices, managed care, and other departments, and communicates with office staff as needed. Performs other related duties as requested. Qualifications License/Registration/Certification: CPC, CCS‑P, or CRC. Education: High School graduate. Experience: At least five years in coding and billing. Knowledge of ICD‑10‑CM and CPT coding systems. Demonstrated ability to accurately assign HCCs and improve risk adjustment coding. Benefits Health benefits Life insurance Long‑term disability coverage Healthcare spending accounts Retirement plan Paid time off Pet insurance Tuition reimbursement Employee assistance program Wellness program On‑site housing for select positions #J-18808-Ljbffr CMP01 Mount Sinai Medical Center of Florida, Inc.