No longer accepting applications
Risk Adjustment Coding Specialist II (Connecticut)
Astrana Health, Inc.Hartford, CT, US12 hours ago
Job type
- Full-time
Job descriptionPut Patients First Empower Entrepreneurial Provider and Care Teams Operate with Integrity & Excellence Be Innovative Work As One Team 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 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. 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 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. The work hours are Monday through Friday, standard business hours.
Job Description
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
- Must reside in Connecticut, Massachusetts, Rhode Island, or New York
Our Values :
What You'll Do
Qualifications
You're great for this role if :
Environmental Job Requirements and Working Conditions
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.
Create a job alert for this search
Coding Specialist Ii • Hartford, CT, US
Related jobs
To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values.
These values - integrity, patient-centered, respect, account...Show moreLast updated: 30+ days ago
Corporate Counsel, P&C and Specialty Risk.The Corporate Counsel, (Property & Casualty and Specialty Risk) provides counsel and support to General Counsel on all legal matters and represents AmTrust...Show moreLast updated: 30+ days ago
Fair Haven Community Health Care FHCHC is a forward-thinking, dynamic, and exciting community health center that provides care for multiple generations at over 143,000 office visits in 21 loc...Show moreLast updated: 30+ days ago
Outsource Human Resource and Staffing firm specializing in, Life Science, Healthcare, Hospitality, Finance and Municipal operations management, based in Milford, CT.
Our mission is to provide superi...Show moreLast updated: 30+ days ago To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values.
These values - integrity, patient-centered, respect, account...Show moreLast updated: 30+ days ago 
Individual contributor role responsible for the handling of Miscellaneous Professional Liability claims for the organization from inception to resolution.
This involves the negotiation and settlemen...Show moreLast updated: 15 days ago
You are a licensed insurance agent, and you want to make a good living helping people protect their families through life insurance.
Not a traditional insurance agent, thats what.Talking about death...Show moreLast updated: 30+ days ago
LocumJobsOnline is working with Weatherby Healthcare to find a qualified Internal Medicine MD in Essex, Connecticut, 06426!.
Interested? Give Weatherby a call today and speak with one of our special...Show moreLast updated: 11 days ago
Internal Medicine physician employment in Connecticut : The Inline Group -.Hours : Monday - Friday No Evenings.Call Schedule : Averages 2 weekends per year and 1 weeknight every 5-6 weeks, phone call ...Show moreLast updated: 24 days ago
CRNA Quality Improvement Specialist? at Yale New Haven Health summary : A Certified Registered Nurse Anesthetist (CRNA) Quality Improvement Specialist delivers safe, patient-centered anesth...Show moreLast updated: 3 days ago
A dynamic organization supplying quality claims outsource solutions to insurance carriers, countrywide is seeking multi-line adjusters in your area.
There are many competing vendors in our marketpla...Show moreLast updated: 30+ days ago
Advanced Radiology Consultants.Advanced Radiology is one of the largest independent radiology practices in the tri-state area with the most experienced radiologists.
We look for team members who wan...Show moreLast updated: 12 days ago
Reporting to : Director, Compensation.The base salary range for this position is dependent upon experience and location, ranging from $113,000 to $142,000 plus up to 16% bonus.The Lead Advisor will ...Show moreLast updated: 2 days ago
Arbella Claim Service Specialist Opportunity.Claim Service Specialists are advocates for our customers.They talk directly with people who have recently experienced a loss, inspect the damage, and i...Show moreLast updated: 30+ days ago To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values.
These values - integrity, patient-centered, respect, account...Show moreLast updated: 30+ days ago 
Start here at Hartford HealthCare and work where every moment matters! •.Hartford HealthCare at Home doesn’t just take great care of our patients.
we take great care of our Registered Nurses too! O...Show moreLast updated: 9 hours ago Accounting And Finance Specialist.Bearingstar Insurance, a member of the Arbella Insurance Group, is one of the leading property and casualty insurance providers in Massachusetts and Connecticut wr...Show moreLast updated: 30+ days ago 
Are you a highly motivated, quality-driven, and reliable? Do you want to work for a customer-focused company that values PEOPLE and PROCESSES while working alongside those with a PASSION for collis...Show moreLast updated: 3 days ago
We are currently seeking qualified candidates for consideration to fill an open Document Control Specialist position in our Program Management Services Division.
This position works out of our Clien...Show moreLast updated: 6 days ago
Management Liability Claims Specialist.IAT Insurance Group has an immediate opening for a Management Liability Claims Specialist that can be located in any of our IAT locations.This role works a hy...Show moreLast updated: 30+ days ago
- Promoted
RN - Trauma ICU - $20,000 Bonus Opportunity
Yale New Haven HealthColchester, CT, USFull-time
- Promoted
Corporate Counsel, P&C and Specialty Risk
AmTrust FinancialSouthington, CT, United StatesFull-time
Dental Billing Specialist
Fair Haven Community Health Carenew haven, CT, USFull-time
Quick Apply
Payroll Specialist II
McInnis Inc.Milford, CT, USFull-time
Quick Apply
- Promoted
RN - $20K RN Bonus Offered
Yale New Haven HealthColchester, CT, USFull-time
- Promoted
Complex Claims Specialist
HiscoxWest Hartford, CT, USFull-time
- Promoted
Licensed Advocate-Remote CT
Origin8CaresAndover, CT, USRemote
Full-time
- Promoted
Locum Physician (MD / DO) - Internal Medicine - General / Other in Essex, CT
LocumJobsOnlineEssex, CT, USFull-time +1
- Promoted
Internal Medicine
The Inline GroupVernon Rockville, Connecticut, USFull-time
- Promoted
CRNA Quality Improvement Specialist?
Yale New Haven HealthBranford, CT, United StatesFull-time
MULTI-LINE ADJUSTER - Connecticut
Property Claim ProfessionalsHartford, CT, USFull-time
Quick Apply
- Promoted
Authorization & Account Verification Specialist
Advanced Radiology ConsultantsShelton, CT, USFull-time
- Promoted
Lead Advisor - Compensation
IberdrolaOrange, CT, USFull-time
- Promoted
Claim Service Specialist - Farmington, CT - Hybrid
Arbella Insurance GroupUnionville, CT, USFull-time
- Promoted
RN - ICU - Sign-On Bonus
Yale New Haven HealthColchester, CT, USFull-time
- New!
Authorization Specialist - Homecare
MediabistroHartford, CT, United StatesFull-time
- Promoted
BIA Agency Accounting and Finance Specialist
Arbella Insurance GroupUnionville, CT, USFull-time
- Promoted
Integration Specialist
VIVE CollisionThomaston, CT, USFull-time
Document Control Specialist (Connecticut)
LaBella AssociatesHartford, CT, USFull-time
Quick Apply
- Promoted
Management Liability Claims Specialist
IAT Insurance GroupCheshire, CT, USFull-time