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PacificSource Administrators, Inc.
Portland, OR, United States
**Position Overview:** The Risk Adjustment Coding Manager will lead our risk adjustment efforts to achieve effective documentation and coding practices while improving provider relationships. The Manager will identify and maximize practice and process improvement opportunities, provider performance trends, educate providers and their practices, aud
Job Source: PacificSource Administrators, Inc.PacificSource Administrators, Inc.
Portland, OR, United States
**Essential Responsibilities:** Manage end-to-end revenue optimization initiatives for PacificSource Medicare Advantage plans and Commercial Exchange plans. Lead cross functional revenue teams. Oversee contracted vendor activities and overall performance in the areas of risk adjustment, coding improvement, chart review, and reconciliation. Develop
Job Source: PacificSource Administrators, Inc.PacificSource Administrators, Inc.
Portland, OR, United States
**Position Overview:** The Senior Risk Adjustment (RA) Analyst assists in the accurate and comprehensive data submission to regulatory entities such as the Centers for Medicare & Medicaid Services (CMS) for all risk adjustable populations. This position leverages available tools and knowledge of the applicable risk models to optimize data submissio
Job Source: PacificSource Administrators, Inc.PacificSource Administrators, Inc.
Portland, OR, United States
**Position Overview:** The Associate Risk Adjustment (RA) Analyst assists in the accurate and comprehensive data submission to regulatory entities such as the Centers for Medicare & Medicaid Services (CMS) for all risk adjustable populations. This position leverages available tools and knowledge of the applicable risk models to optimize data submis
Job Source: PacificSource Administrators, Inc.Providence Health & Services
Portland, OR, United States
Description The Coder 1 performs coding audits and review of outpatient provider services to support coding optimization and compliance for the medical group. This is an entry level position supporting multiple specialties across the medical group with coding for evaluation and management and procedural services. In addition to the audit and revie
Job Source: Providence Health & ServicesProvidence
Vancouver
**Description** The Coder 1 performs coding audits and review of outpatient provider services to support coding optimization and compliance for the medical group. This is an entry level position supporting multiple specialties across the medical group with coding for evaluation and management and procedural services. In addition to the audit and re
Job Source: ProvidenceProvidence
Hillsboro
**Description** The Coder 1 performs coding audits and review of outpatient provider services to support coding optimization and compliance for the medical group. This is an entry level position supporting multiple specialties across the medical group with coding for evaluation and management and procedural services. In addition to the audit and re
Job Source: ProvidenceProvidence
Milwaukie
**Description** The Coder 1 performs coding audits and review of outpatient provider services to support coding optimization and compliance for the medical group. This is an entry level position supporting multiple specialties across the medical group with coding for evaluation and management and procedural services. In addition to the audit and re
Job Source: ProvidencePortland
Medical Coder - Risk Adjustment (Risk Adjustment Auditor II)
Work from home within Oregon, Washington, Idaho or Utah
Build a career with purpose. Join our Cause 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.
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Email Alert for Medical Coder - Risk Adjustment jobs in Portland
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