Talent.com
Risk Adjustment Coding Specialist II (Northern Virginia)

Risk Adjustment Coding Specialist II (Northern Virginia)

Astrana Health, Inc.Virginia, US
30+ days ago
Job type
  • Full-time
  • Quick Apply
Job description

Description

We are currently seeking a highly motivated Risk Adjustment Coding Specialist II. This role will report to a Sr. Manager - Risk Adjustment and will conduct provider medical record audits, analysis of practice coding patterns, education and training regarding risk adjustment to ensure accurate CMS payment and improve quality of care.

  • Requires travel to provider sites in surrounding areas

Our Values :

  • Put Patients First
  • Empower Entrepreneurial Provider and Care Teams
  • Operate with Integrity & Excellence
  • Be Innovative
  • Work As One Team
  • What You'll Do

  • Review provider documentation of diagnostic data from medical records to verify that all Medicare Advantage, Affordable Care Act (ACO) and Commercial risk adjustment documentation requirements are met, and to deliver education to providers on either an individual basis or in a group forum, as appropriate for all IPAs managed by the company
  • Review medical record information on both a retroactive and prospective basis to identify, assess, monitor, and document claims and encounter coding information as it pertains to Hierarchical Condition Categories (HCC)
  • Perform code abstraction and / or coding quality audits of medical records to ensure ICD-10- CM codes are accurately assigned and supported by clinical documentation to ensure adherence with CMS Risk Adjustment guidelines
  • Interacts with physicians regarding coding, billing, documentation policies, procedures, and conflicting / ambiguous or non-specific documentation
  • Prepare and / or perform auditing analysis and provide feedback on noncompliance issues detected through auditing
  • Maintain current knowledge of coding regulations, compliance guidelines, and updates to the ICD-10 and HCC codes, Stay informed about changes in Medicare, Medicaid, and private payer requirements.
  • Provides recommendations to management related to process improvements, root-cause analysis, and / or barrier resolution applicable to Risk Adjustment initiatives.
  • Trains, mentors and supports new employees during the orientation process. Functions as a resource to existing staff for projects and daily work.
  • Provides peer to peer guidance through informal discussion and overread assignments. Supports coder training and orientation as requested by manager.
  • May assist or lead projects and / or higher work volume than Risk Adjustment Coding Specialist I
  • Qualifications

  • Must possess and maintain AAPC or AHIMA certification - Certified Risk Adjustment Coder (CRC) & Certified Coding Specialist (CCS-P), CCS, CPC
  • 3-5+ years of experience in risk adjustment coding and / or billing experience required
  • Reliable transportation / Valid Driver’s License / Must be able to travel up to 75% of work time, if applicable.
  • PC skills and experience using Microsoft applications such as Word, Excel, and Outlook
  • Excellent presentation, verbal and written communication skills, and ability to collaborate
  • Must possess the ability to educate and train provider office staff members
  • Proficiency with healthcare coding software and Electronic Health Records (EHR) systems.
  • You're great for this role if :

  • Strong billing knowledge and / or Certified Professional Biller (CPB) through APPC
  • Have knowledge of Risk Adjustment and Hierarchical Condition Categories (HCC) for Medicare Advantage
  • Strong PowerPoint and public speaking experience
  • Strong experience with Excel - pivot tables, VLOOKUP, etc.
  • Ability to work independently and collaborate in a team setting
  • Experience with Monday.com
  • Experience collaborating with, educating, and presenting to provider teams in a face-to-face setting
  • Environmental Job Requirements and Working Conditions

  • The total pay range for this role is $75,000 - $85,000 per year. This salary range represents our national target range for this role.
  • This role follows a hybrid work structure where the expectation is to work on the field and at home on a weekly basis. This position requires up to 75% travel to provider offices in the surrounding areas in Northern Virginia.
  • The work hours are Monday through Friday, standard business hours.
  • Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation.

    Astrana Health (NASDAQ : ASTH) is a physician-centric, technology-powered healthcare management company. We are building and operating a novel, integrated, value-based healthcare delivery platform to empower our physicians to provide the highest quality of end-to-end care for their patients in a cost-effective manner. Our mission is to combine our clinical experience, best-in-class delivery network, and technological expertise to improve patient outcomes, increase access to healthcare, and make the US healthcare system more efficient.

    Our platform currently empowers over 20,000 physicians to provide care for over 1.7 million patients nationwide. Our rapid growth and unique position at the intersection of all major healthcare stakeholders (payer, provider, and patient) gives us an unparalleled opportunity to combine clinical and technological expertise to improve patient outcomes, increase access to quality healthcare, and reduce the waste in the US healthcare system.

    Create a job alert for this search

    Coding Specialist Ii • Virginia, US

    Related jobs
    • Promoted
    CT Tech I - Southside Community Hospital - Thurs / Fri / Sat 7p-7a

    CT Tech I - Southside Community Hospital - Thurs / Fri / Sat 7p-7a

    Centra Health, IncFarmville, VA, United States
    Full-time
    BONUS ELIGIBLE - $20K for new grads & experienced CT Techs! The CT Technologist I performs radiographic procedures using ionizing radiation for radiologic diagnosis, cares for patients, and assists...Show moreLast updated: 30+ days ago
    • Promoted
    Travel CT Tech - $2,274 per week in Farmville, VA

    Travel CT Tech - $2,274 per week in Farmville, VA

    AlliedTravelCareersFarmville, VA, US
    Full-time +1
    AlliedTravelCareers is working with Focus Staff to find a qualified CT Tech in Farmville, Virginia, 23901!.The ideal candidate will have at least 1 year of experience in a CT Tech / X-Ray Tech settin...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Nurse RN - Telemetry - $1,647 to $1,826 per week in Farmville, VA

    Travel Nurse RN - Telemetry - $1,647 to $1,826 per week in Farmville, VA

    TravelNurseSourceFarmville, VA, US
    Full-time
    TravelNurseSource is working with LRS Healthcare to find a qualified Telemetry RN in Farmville, Virginia, 23901!.Ready to start your next travel adventure? LRS Healthcare offers a full benefits pac...Show moreLast updated: 30+ days ago
    • Promoted
    Cyber Warfare Technician

    Cyber Warfare Technician

    U.S. NavyMonroe, VA, United States
    Full-time +1
    To be eligible to enlist in the U.Navy, candidates must be between the ages of 18-34.As a Cryptologic Technician, you are one of the worlds greatest problem-solvers. Were looking for people with sha...Show moreLast updated: 30+ days ago
    • Promoted
    Travel MRI Tech - $2742.4 / Week

    Travel MRI Tech - $2742.4 / Week

    FlexCareFarmville, VA, US
    Full-time
    FlexCare is seeking an experienced MRI Tech for an exciting Travel Allied job in Farmville, VA.Shift : 5x8 hr days Start Date : ASAP Duration : 13 weeks Pay : $2742. NOTE : THIS IS A TRAVEL STAFFING ASSI...Show moreLast updated: 30+ days ago
    • Promoted
    Travel CT Tech - $2361 / Week

    Travel CT Tech - $2361 / Week

    Medpro Healthcare StaffingFarmville, VA, US
    Full-time
    Medpro Healthcare Staffing is seeking an experienced CT Tech for an exciting Travel Allied job in Farmville, VA.Shift : 3x12 hr nights Start Date : 11 / 03 / 2025 Duration : 13 weeks Pay : $2361 / Week.Joi...Show moreLast updated: 30+ days ago
    • Promoted
    Travel CT Tech - $2080 / Week

    Travel CT Tech - $2080 / Week

    Fusion Medical StaffingFarmville, VA, US
    Full-time
    Fusion Medical Staffing is seeking an experienced CT Tech for an exciting Travel Allied job in Farmville, VA.Shift : Inquire Start Date : ASAP Duration : 13 weeks Pay : $2080 / Week.Facility in Farmvil...Show moreLast updated: 30+ days ago
    • Promoted
    MRI Tech I - PRN / Farmville, Va.

    MRI Tech I - PRN / Farmville, Va.

    Centra Health, IncFarmville, VA, United States
    Full-time
    As a member of the Radiology Patient Care Team, the Magnetic Resonance Imaging Technologist performs high quality MRI exams. The MRI Tech operates Magnetic Resonance Imaging (MRI) scanners, monitors...Show moreLast updated: 30+ days ago
    • Promoted
    Travel CT Tech - $2506.94 / Week

    Travel CT Tech - $2506.94 / Week

    Host HealthcareFarmville, VA, US
    Full-time
    Host Healthcare is seeking an experienced CT Tech for an exciting Travel Allied job in Farmville, VA.Shift : 12 hr nights Start Date : 10 / 20 / 2025 Duration : 13 weeks Pay : $2506.At Host Healthcare, we ...Show moreLast updated: 30+ days ago
    • Promoted
    Travel CT Tech - $1,921 to $2,129 per week in Farmville, VA

    Travel CT Tech - $1,921 to $2,129 per week in Farmville, VA

    AlliedTravelCareersFarmville, VA, US
    Full-time
    AlliedTravelCareers is working with LRS Healthcare to find a qualified CT Tech in Farmville, Virginia, 23901!.Ready to start your next travel adventure? LRS Healthcare offers a full benefits packag...Show moreLast updated: 30+ days ago
    • Promoted
    Travel CT Tech - $2,413 per week in Farmville, VA

    Travel CT Tech - $2,413 per week in Farmville, VA

    AlliedTravelCareersFarmville, VA, US
    Full-time +1
    AlliedTravelCareers is working with Infojini Healthcare to find a qualified CT Tech in Farmville, Virginia, 23901!.CT Tech travel Radiology / Imaging needed in Farmville, Virginia.Self Assessment (Sk...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Ultrasound Technologist

    Travel Ultrasound Technologist

    Infojini HealthcareFarmville, VA, US
    Full-time +1
    Infojini Healthcare is seeking a travel Ultrasound Technologist for a travel job in Farmville, Virginia.Job Description & Requirements. Infojini Healthcare Job ID #157259.Pay package is based on...Show moreLast updated: 2 days ago
    • Promoted
    Travel Ultrasound Tech - $1,809 to $2,005 per week in Farmville, VA

    Travel Ultrasound Tech - $1,809 to $2,005 per week in Farmville, VA

    AlliedTravelCareersFarmville, VA, US
    Full-time
    AlliedTravelCareers is working with LRS Healthcare to find a qualified Ultrasound in Farmville, Virginia, 23901!.Ready to start your next travel adventure? LRS Healthcare offers a full benefits pac...Show moreLast updated: 10 days ago
    • Promoted
    Travel CT Tech - $2330 / Week

    Travel CT Tech - $2330 / Week

    Cynet HealthFarmville, VA, US
    Full-time
    Cynet Health is seeking an experienced CT Tech for an exciting Travel Allied job in Farmville, VA.Shift : 3x12 hr nights Start Date : 10 / 20 / 2025 Duration : 13 weeks Pay : $2330 / Week.Ranked #5 Best Tr...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Ultrasound Tech - $1,928 to $2,081 per week in Farmville, VA

    Travel Ultrasound Tech - $1,928 to $2,081 per week in Farmville, VA

    AlliedTravelCareersFarmville, VA, US
    Full-time
    AlliedTravelCareers is working with Host Healthcare to find a qualified Ultrasound in Farmville, Virginia, 23901!.Host Healthcare is an award-winning travel healthcare company with an immediate ope...Show moreLast updated: 10 days ago
    • Promoted
    Travel CT Technologist

    Travel CT Technologist

    ARMStaffingFarmville, VA, US
    Full-time
    ARMStaffing is seeking a travel CT Technologist for a travel job in Farmville, Virginia.Job Description & Requirements.CT Technologist - Night Shift\n\n. This position is located in an undisclos...Show moreLast updated: 30+ days ago
    • Promoted
    Clinical Registered Nurse II-Specialty A-SCH ICU (FT / 7P-7A)

    Clinical Registered Nurse II-Specialty A-SCH ICU (FT / 7P-7A)

    Centra Health, IncFarmville, VA, US
    Full-time
    The professional registered nurse (RN) plans, coordinates, and manages the care provided to assigned patients and practices under the tenets of Centra's Professional Practice Model.The RN acts ...Show moreLast updated: 30+ days ago
    • Promoted
    Clinical Registered Nurse II-Specialty B-OR / FT Variable Shifts

    Clinical Registered Nurse II-Specialty B-OR / FT Variable Shifts

    Centra Health, IncLynchburg, VA, United States
    Full-time
    The professional registered nurse (RN) plans, coordinates, and manages the care provided to assigned patients and practices under the tenets of Centra's Professional Practice Model.The RN acts as t...Show moreLast updated: 30+ days ago