Medicare Risk Adjustment Specialist - Medical Assistant

Medicare Risk Adjustment Specialist

Searching for a strong Medical Assistant or Certified Nursing Assistant for a rapidly growing company who would like to come off the floor and become a Medicare Risk Adjustment Specialist.

Essential Job Functions:

• Reviews medical record and claims information to identify all appropriate coding based on Centers for Medicare and Medicaid Services Hierarchical Condition Categories (CMS-HCC & HHS-HCC) models
• Abstract all risk adjusted diagnosis codes from acceptable provider documentation and in accordance with industry standards for coding and reporting.
• Adherence to current industry standard, as defined in the ICD-10 guidelines for coding and reporting.
• Conduct Provider queries for any documentation for risk conditions within client electronic medical record and/or other query system
• Develop and share guidelines/best practices with internal risk adjustment coders to improve coding documentation techniques.
• Help with special projects within our Risk Adjustment Department

Knowledge/Skills/Abilities:

• Critical Thinking
• Excellent time management skills and ability to multi-task and prioritize work
• Strong organizational and planning skills
• Flexibility
• Team Player
• Autonomy

Minimum Requirements:

• High School Diploma or Equivalent (Required)
• Medical Assistant or Certified Nursing Assistant
• 2 -- 3 years Back Office, Primary Care preferred

Working Environment:

The position requires climbing, stooping, kneeling, crouching, reaching, standing, lifting, grasping, feeling, talking, hearing, repetitive motions, and finger use. Pushing and pulling are occasionally required. Use of a computer, keyboard, and telephone along with various office machines is an essential part of the job.

Disclaimer:

The above statements are intended to describe the general nature and level of work being performed by the Medicare Risk Adjustment Coder. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. The Medicare Risk Adjustment Coder may be required to perform duties outside of their normal responsibilities from time to time as needed or as directed by supervision.