Medical Coder - Risk Adjustment

Medical Coder Risk Adjustment (Risk Adjustment Auditor II)

Work from home within Oregon, Washington, Idaho or Utah

Build a career with purpose. Join our to create a person-focused and economically sustainable health care system.

Who We Are Looking For :

Every day, Cambia’s dedicated team of Medical Coders Risk Adjustment (Risk Adjustment Auditor II) is living our mission to make health care easier and lives better.

As a member of the Risk Adjustment team, our Risk Adjustment Medical Coders performs Retrospective / Prospective chart review both on and off-site utilizing various types of records to ensure accurate risk adjustment reporting.

Identifies trends in provider coding / documentation and works closely with Provider Education Consultants to develop intervention strategies all in service of creating a person-focused health care experience.

Do you thrive as part of a collaborative, caring team? Then this role may be the perfect fit.

What You Bring to Cambia :

Qualifications :

Medical Coder Risk Adjustment (Risk Adjustment Auditor II) would have an Associate degree in Healthcare or related field and three years of experience in clinical coding or auditing or equivalent combination of education and experience.

Coding Certification (CCA, CCS, CCS-P, CPC, or CPC-P) required. Risk Adjustment, HCC or Inpatient coding experience preferred.

Skills and Attributes :

Knowledge of and adherence to Official ICD-9-CM / ICD-10 Coding Guidelines.

Demonstrated ability to perform accurate and complete chart reviews for risk adjustment.

Demonstrates analytical ability to identify problems, develop solutions, and implement actions in a timely manner.

Demonstrated ability to identify and communicate trends in provider coding and documentation.

Effective verbal and written communication skills.

What You Will Do at Cambia :

Performs Retrospective and Prospective chart reviews to ensure accurate risk adjustment reporting.

Verifies and ensures the accuracy, completeness, specificity and appropriateness of provider-reported diagnosis codes based on medical record documentation.

Reviews medical record information to identify complete and accurate diagnosis code capture based on CMS HCC categories.

Identifies trends in provider coding and documentation and partners with Provider Education Consultants to develop intervention strategies.

Supports and actively participates in process and quality improvement initiatives.

Maintains knowledge of relevant regulatory mandates and ensures activities are in compliance with requirements.

Monitors and interprets regulatory changes that may impact administration of the Risk Adjustment Program. Assists with implementation activities as a result of regulatory changes to the Program.

The expected hiring range for a Medical Coder Risk Adjustment (Risk Adjustment Auditor II) is $68,000.00 - $92,000.00 depending on skills, experience, education, and training;

relevant licensure / certifications; performance history; and work location. The bonus target for this position is 10%. The current full salary range for this role is $64,000.00 to $104,000.00.

LI-remote

About Cambia

Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation anchored in our 100+ year history.

Our caring and supportive colleagues are some of the best and brightest in the industry, innovating together toward sustainable, person-focused health care.

Whether we're helping members, lending a hand to a colleague or volunteering in our communities, our compassion, empathy and team spirit always shine through.

Why Join the Cambia Team?

At Cambia, you can :

• Work alongside diverse teams building cutting-edge solutions to transform health care.
• Earn a competitive salary and enjoy generous benefits while doing work that changes lives.
• Grow your career with a company committed to helping you succeed.
• Give back to your community by participating in Cambia-supported outreach programs.
• Connect with colleagues who share similar interests and backgrounds through our employee resource groups.

We believe a career at Cambia is more than just a paycheck and your compensation should be too. Our compensation package includes competitive base pay as well as a market-leading 401(k) with a significant company match, bonus opportunities and more.

In exchange for helping members live healthy lives, we offer benefits that empower you to do the same. Just a few highlights include :

• Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits.
• Annual employer contribution to a health savings account.
• Generous paid time off varying by role and tenure in addition to 10 company-paid holidays.
• Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period).
• Up to 12 weeks of paid parental time off (eligible day one of employment if within first 12 months following birth or adoption).
• Award-winning wellness programs that reward you for participation.
• Employee Assistance Fund for those in need.
• Commute and parking benefits.

Learn more about our .

We are happy to offer work from home options for most of our roles. To take advantage of this flexible option, we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb.

We are an Equal Opportunity and Affirmative Action employer dedicated to workforce diversity and a drug and tobacco-free workplace.

All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law.

A background check is required.

If you need accommodation for any part of the application process because of a medical condition or disability, please email .

Information about how Cambia Health Solutions collects, uses, and discloses information is available in our .