Risk Data Specialist
4 weeks ago
Job Summary
We are seeking a highly skilled Risk Data Specialist to join our team at Loma Linda University Medical Center. As a key member of our team, you will be responsible for ensuring the accuracy and completeness of clinical documentation related to Risk Adjustment Data Validation (RADV) timelines.
Key Responsibilities
- Conduct concurrent, prospective, and retrospective clinical documentation review to ensure compliance with RADV timelines.
- Collaborate with providers to ensure accurate and complete documentation of severity of illness and supporting clinical care plans.
- Stay up-to-date on CMS, ICD-10-CM, AHA Coding, and health plan guidelines related to Risk Adjustment.
- Identify trends and opportunities for improvement in documentation integrity.
Requirements
- Bachelor's degree in Health Information Management or other clinical/healthcare degree.
- 2+ years of combined clinical/medical experience, with at least 1+ year of Risk Adjustment coding specific experience or Clinical Documentation Improvement/Specialist equivalent.
- Certified Risk Adjustment Coder (CRC) required.
Preferred Qualifications
- Comprehensive understanding of electronic medical records, medical terminology, abbreviations, and ICD-10-CM coding conventions.
- Expertise in CMS Risk Adjustment Data Validation (RADV) for Medicare Advantage Plans, and medical coding, including E/M, ICD-10, CPT, and HCC coding.
What We Offer
- A dynamic and supportive work environment.
- Opportunities for professional growth and development.
- A competitive salary and benefits package.
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