Licensed Risk Adjustment Coding Analyst

A company is looking for a Senior Risk Adjustment Coding Compliance Analyst (Clinical).

Key Responsibilities

Execute oversight of Risk Adjustment activities, including monitoring and auditing medical records for accurate diagnosis coding

Collaborate with coding teams to enhance documentation practices and ensure compliance with regulatory guidelines

Conduct gap analyses and provide recommendations for improving risk adjustment quality programs

Required Qualifications, Training, and Education

High School Diploma or GED required; Bachelor's Degree in Nursing, Healthcare Management, Business Management or related field preferred

5+ years of professional coding experience in a hospital or physician setting required

Experience in Managed care preferred

Licensure as LVN, LPN, or RN required; Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) required

Certified Risk Adjustment (CRC) preferred