Healthcare Risk Adjustment Coding Specialist

7 days ago


Winter Park, Florida, United States Wellvana Full time
About the Role

We are seeking a highly skilled Healthcare Risk Adjustment Coding Specialist to join our team at Wellvana. This is an excellent opportunity for a motivated and detail-oriented professional to make a meaningful impact in the healthcare industry.

Job Summary

The Healthcare Risk Adjustment Coding Specialist will be responsible for partnering with Wellvana affiliated practices and health systems on all aspects of risk adjustment coding, regulatory requirements, and proper documentation procedures for attributed patients in Medicare Advantage, MSSP, and ACO Reach programs.

Key Responsibilities
  • Review clinical data and available patient documentation to confirm patient diagnoses in advance of in-office physician visits.
  • Personalize individual physician and practice feedback and identify coding trends and documentation patterns from data retrieved by coding reviews and audits.
  • Maintain a comprehensive schedule and visit log, documenting and storing all materials utilized in practice and health system discussions.
Requirements

To be successful in this role, you will need:

  • A thorough understanding of the mechanics of risk adjustment coding and HCC Risk Adjustment Model Categorical Hierarchy.
  • Demonstrated ability to communicate complex knowledge effectively to physicians and their practice leaders.
  • Expertise in prospective, retrospective, and concurrent review processes.
  • Strong analytical and problem-solving skills, with the ability to identify areas for improvement in clinical documentation and quality education programs.
  • Effective communication and interpersonal skills, with a commitment to continuous learning and staying updated on industry trends.
What We Offer

We offer a competitive salary of $95,000 - $110,000 per year, based on experience, plus a range of benefits including medical, dental, and vision insurance, 401(k) matching, and paid time off.



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