Talent.com
No longer accepting applications
Risk Adjustment Coding Specialist II (Central Georgia)

Risk Adjustment Coding Specialist II (Central Georgia)

Astrana Health, Inc.Alhambra, CA, US
16 hours ago
Job type
  • Full-time
Job description

Job Description

Job Description

Description

We are currently seeking a highly motivated Risk Adjustment Coding Specialist. This role will report to a Sr. Manager - Risk Adjustment and enable us to continue to scale in the healthcare industry.

  • 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 Central Georgia.
  • 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.

    Create a job alert for this search

    Coding Specialist Ii • Alhambra, CA, US

    Related jobs
    • Promoted
    Side gig : Earn at least $620 in your first 64 trips with Uber, guaranteed.

    Side gig : Earn at least $620 in your first 64 trips with Uber, guaranteed.

    UberLytle Creek, CA, United States
    Full-time +1
    Earn at least $620 driving with Uber when you complete your first 64 trips in 30 days.Driving is an easy way to boost your income while maintaining the flexibility your schedule requires (gig, part...Show moreLast updated: 3 days ago
    • Promoted
    Side gig - Earn at least $620 in your first 64 trips with Uber, guaranteed.

    Side gig - Earn at least $620 in your first 64 trips with Uber, guaranteed.

    UberLytle Creek, CA, United States
    Full-time +1
    Earn at least $620 driving with Uber when you complete your first 64 trips in 30 days.Driving is an easy way to boost your income while maintaining the flexibility your schedule requires (gig, part...Show moreLast updated: 3 days ago
    • Promoted
    Part-time gig : Earn at least $620 in your first 64 trips.

    Part-time gig : Earn at least $620 in your first 64 trips.

    UberLytle Creek, CA, United States
    Full-time +1
    Earn at least $620 driving with Uber when you complete your first 64 trips in 30 days.Driving is an easy way to boost your income while maintaining the flexibility your schedule requires (gig, part...Show moreLast updated: 3 days ago
    • Promoted
    • New!
    Manager, Risk Adjustment, Medical Coding

    Manager, Risk Adjustment, Medical Coding

    Kaiser PermanentePasadena, CA, US
    Full-time
    Manager, Risk Adjustment, Medical Coding.This position is flexible and must be based in a KP location, CA, OR, CO, WA, GA, MD, VA, HI or D. In addition to the responsibilities listed below, the posi...Show moreLast updated: less than 1 hour ago
    • Promoted
    Consultant II

    Consultant II

    Kaiser PermanentePasadena, CA, US
    Full-time
    The Benefits Administration Coding Team (BACT) is a dynamic team composed of certified medical coding professionals.BACT closely partners with the benefit policy team to codify policy language into...Show moreLast updated: 30+ days ago
    • Promoted
    Tax Expert - Onsite

    Tax Expert - Onsite

    IntuitPhelan, CA, United States
    Full-time
    Intuit is seeking highly motivated individuals to join our dynamic team as dedicated TurboTax Live Seasonal Local Service Experts in one of our new TurboTax locations across the United States on a ...Show moreLast updated: 13 days ago
    • Promoted
    Tax Expert - 2+ Yrs Paid Tax Experience Required

    Tax Expert - 2+ Yrs Paid Tax Experience Required

    IntuitPhelan, CA, United States
    Full-time
    Intuit is seeking highly motivated individuals to join our dynamic team as dedicated TurboTax Live Seasonal Local Service Experts in one of our new TurboTax locations across the United States on a ...Show moreLast updated: 6 days ago
    • Promoted
    Payroll Specialist

    Payroll Specialist

    Vaco by HighspringAltadena, California, United States
    Full-time
    Payroll Specialist who will be responsible time keeping records of employees’ hours worked as well as any deductions or withholdings required to comply with state and federal laws in all of our mar...Show moreLast updated: 24 days ago
    • Promoted
    Flexible $ : Earn At Least $620 For Your First 64 Trips, Guaranteed.

    Flexible $ : Earn At Least $620 For Your First 64 Trips, Guaranteed.

    UberLytle Creek, CA, United States
    Full-time +1
    Earn at least $620 driving with Uber when you complete your first 64 trips in 30 days.Driving is an easy way to boost your income while maintaining the flexibility your schedule requires (gig, part...Show moreLast updated: 3 days ago
    • Promoted
    Flexible schedule - Earn at least $620 by driving 64 trips with Uber

    Flexible schedule - Earn at least $620 by driving 64 trips with Uber

    UberPhelan, CA, United States
    Full-time +1
    Earn at least $620 driving with Uber when you complete your first 64 trips in 30 days.Driving is an easy way to boost your income while maintaining the flexibility your schedule requires (gig, part...Show moreLast updated: 3 days ago
    • Promoted
    Drive with Uber : Earn at least $620 when you complete 64 trips.

    Drive with Uber : Earn at least $620 when you complete 64 trips.

    UberPhelan, CA, United States
    Full-time +1
    Earn at least $620 driving with Uber when you complete your first 64 trips in 30 days.Driving is an easy way to boost your income while maintaining the flexibility your schedule requires (gig, part...Show moreLast updated: 3 days ago
    • Promoted
    Side gig : Earn at least $620 in your first 64 trips driving, guaranteed.

    Side gig : Earn at least $620 in your first 64 trips driving, guaranteed.

    UberLytle Creek, CA, United States
    Full-time +1
    Earn at least $620 driving with Uber when you complete your first 64 trips in 30 days.Driving is an easy way to boost your income while maintaining the flexibility your schedule requires (gig, part...Show moreLast updated: 3 days ago
    • Promoted
    Drive With Uber : Earn At Least $620 For Your First 64 Trips, Guaranteed.

    Drive With Uber : Earn At Least $620 For Your First 64 Trips, Guaranteed.

    UberPhelan, CA, United States
    Full-time +1
    Earn at least $620 driving with Uber when you complete your first 64 trips in 30 days.Driving is an easy way to boost your income while maintaining the flexibility your schedule requires (gig, part...Show moreLast updated: 3 days ago
    • Promoted
    Driver gig - Earn at least $620 by driving 64 trips with Uber

    Driver gig - Earn at least $620 by driving 64 trips with Uber

    UberLytle Creek, CA, United States
    Full-time +1
    Earn at least $620 driving with Uber when you complete your first 64 trips in 30 days.Driving is an easy way to boost your income while maintaining the flexibility your schedule requires (gig, part...Show moreLast updated: 3 days ago
    • Promoted
    Fast Pay - Earn at least $620 in your first 64 trips, guaranteed.

    Fast Pay - Earn at least $620 in your first 64 trips, guaranteed.

    UberPhelan, CA, United States
    Full-time +1
    Earn at least $620 driving with Uber when you complete your first 64 trips in 30 days.Driving is an easy way to boost your income while maintaining the flexibility your schedule requires (gig, part...Show moreLast updated: 3 days ago
    • Promoted
    Part-time gig : Earn at least $620 for your first 64 trips, guaranteed.

    Part-time gig : Earn at least $620 for your first 64 trips, guaranteed.

    UberLytle Creek, CA, United States
    Full-time +1
    Earn at least $620 driving with Uber when you complete your first 64 trips in 30 days.Driving is an easy way to boost your income while maintaining the flexibility your schedule requires (gig, part...Show moreLast updated: 3 days ago
    • Promoted
    Earn At Least $620 For Your First 64 Trips, Guaranteed.

    Earn At Least $620 For Your First 64 Trips, Guaranteed.

    UberPhelan, CA, United States
    Full-time +1
    Earn at least $620 driving with Uber when you complete your first 64 trips in 30 days.Driving is an easy way to boost your income while maintaining the flexibility your schedule requires (gig, part...Show moreLast updated: 3 days ago
    • Promoted
    Choose your schedule - Earn At Least $620 For Your First 64 Trips, Guaranteed.

    Choose your schedule - Earn At Least $620 For Your First 64 Trips, Guaranteed.

    UberLytle Creek, CA, United States
    Full-time +1
    Earn at least $620 driving with Uber when you complete your first 64 trips in 30 days.Driving is an easy way to boost your income while maintaining the flexibility your schedule requires (gig, part...Show moreLast updated: 3 days ago
    • Promoted
    Quick Earnings : Earn At Least $620 For Your First 64 Trips, Guaranteed.

    Quick Earnings : Earn At Least $620 For Your First 64 Trips, Guaranteed.

    UberLytle Creek, CA, United States
    Full-time +1
    Earn at least $620 driving with Uber when you complete your first 64 trips in 30 days.Driving is an easy way to boost your income while maintaining the flexibility your schedule requires (gig, part...Show moreLast updated: 3 days ago
    Risk Adjustment Coding Specialist II (San Gabriel Valley, CA)

    Risk Adjustment Coding Specialist II (San Gabriel Valley, CA)

    Astrana Health, Inc.Monterey Park, California, US
    Full-time
    Quick Apply
    We are currently seeking a highly motivated Risk Adjustment Coding Specialist.Manager - Risk Adjustment and enable us to continue to scale in the healthcare industry. May be open to considering Leve...Show moreLast updated: 30+ days ago