Risk adjustment coder

2 weeks ago


Newark, New Jersey, United States Collabera Full time
Job DescriptionJob Description

100% Remote position for NJ, NY, CT, DE, PA state of candidate.

  • About the Role: We are seeking a Senior Professional Coder to join our team and provide services for code abstraction using the Official Coding Guidelines for ICD-9-CM/ICD-10-CM.
  • The Senior Professional Coder will be responsible for activities related to Commercial Risk Adjustment, Medicare Advantage Risk Adjustment, Commercial IVA, and Medicare RADV. This role requires maintaining a minimum accuracy of 95% on coding quality audits.
  • Responsibilities: Compile chart review findings statistics, analyze data results, and implement action plans to improve providers' performance levels
  • Educate new staff on high-quality data abstraction and chart reviews
  • Develop quality assurance processes to ensure data integrity of all submitted diagnoses
  • Evaluate and improve risk adjustment coding programs, policies, and procedures
  • Work closely with inter departmental team management to support coding initiatives
  • Act as a Subject Matter Expert to identify opportunities for business growth
  • Educate management on current changes in regulations/guidance related to ICD-10 coding
  • Collaborate with operations and clinical leadership to identify coding and documentation improvements - Conduct mock audits targeting problematic diagnoses
  • Review medical records for accuracy and compliance with coding guidelines
  • Education Qualification: Current Registered Health Information Technologies (RHIT) or Certified Professional Coder designation from the American Academy of Professional Coders or a Certified Coding Specialist from the American Health Information Management (AHIMA)
  • Bachelor's degree required Required Skills: 5+ years of Medical Coding experience
  • 5+ years of experience in Health Insurance/quality chart audits and/or Utilization Review
  • Proficiency in CPT-4, HCPC, ICD-9/ICD-10 coding
  • Knowledge of medical terminology, procedures, abbreviations, and terms
  • Familiarity with the health care delivery system
  • Ability to utilize a personal computer and relevant software
Company DescriptionCollabera is a Global Digital Solutions Company providing Software Engineering Solutions for the world's most tech-forward organizations in the areas of Engineering, Cloud and Data/AI. With its roots serving the engineering needs of the world's most recognized businesses in Technology, Financial Services, Telecom and Healthcare, Collabera today operates across 60 locations in 11 countries, serves 30% of the Fortune 500, and has exceeded the industry growth rate by 3-4x for several years.Company DescriptionCollabera is a Global Digital Solutions Company providing Software Engineering Solutions for the world's most tech-forward organizations in the areas of Engineering, Cloud and Data/AI. With its roots serving the engineering needs of the world's most recognized businesses in Technology, Financial Services, Telecom and Healthcare, Collabera today operates across 60 locations in 11 countries, serves 30% of the Fortune 500, and has exceeded the industry growth rate by 3-4x for several years.

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