Certified Risk Adjustment Coding Specialist

4 weeks ago


Livonia, Michigan, United States Trinity Health Full time
Job Summary

We are seeking a highly skilled Certified Risk Adjustment Coding Specialist to join our team at Trinity Health PACE Corp Michigan. As a key member of our team, you will be responsible for assigning ICD/CPT codes to participant health information for data retrieval, analysis, and claims processing.

Key Responsibilities
  • Evaluate medical records to identify diagnoses and procedures and accurately assign and sequence ICD and CPT codes.
  • Abstract and validate information, seeking out validating information as needed.
  • Conduct documentation spot checks and respond to audit feedback.
  • Ensure timely, accurate client care documentation for billing.
  • Monitor and inform manager of records that are not completed timely.
  • Stay updated on coding guidelines and reimbursement requirements.
  • Maintain participant confidentiality and abide by HIPAA guidelines.
Requirements
  • High school diploma or equivalent required.
  • 2 years of completed college coursework preferred.
  • Must have one of the following certifications: Certified Outpatient Coder, Certified Coding Specialist, Certified Professional Coder thru AAPC or Registered Health Information Technologist or Registered Health Information Administrator thru AHIMA.
  • Must be certified or obtaining certification for Certified Risk Adjustment Coder thru AAPC. If not obtaining, must obtain within one year if hired.
  • Two-years of experience in a risk adjustment coding environment required.
  • Demonstrated the ability to verify and validate HCCs.
  • Demonstrated the knowledge and ability to work with providers on education and guidance.
  • Demonstrated knowledge of medical terminology, human anatomy and physiology, and diseases processes.
  • Strong communication, problem-solving, customer service, critical thinking, and organizational skills.
What We Offer
  • Comprehensive benefits including 1st Day medical coverage, dental, vision, paid time off, 403B and educational assistance.
  • Access to daily pay and employee referral incentives.
  • Supportive environment with a patient-centered focus.
  • Opportunities for professional development.
About Trinity Health

Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. We are guided by core values of reverence, commitment, safety, justice, stewardship, and integrity. Our commitment to diversity and inclusion is reflected in our mission to provide high-quality care to seniors in the communities we serve.



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