|Employer:||Avec Health Solutions
|Required Certifications:||CPMA,CPC,CCS,or CRC
|Required Experience:||3 to 4 years
|Preferred Experience:||5 to 7 years
This is an exceptional
opportunity to do innovative work that means more to you and those we serve at a
large health group in Fort Meyers, Florida.
Risk Adjustment Coding Auditor
- Responsible for ensuring complete
risk scores and accurate revenue and mitigating payment error risk via
auditing, education, and training for proper diagnosis coding and
- Primary duties may include, but
are not limited to:
- Identifies opportunities to
improve accuracy and completeness for revenue impact.
- Translates data to provide
answers for provider consultations in order to improve medical record
documentation and risk scores.
- Provides feedback to providers
on performance improvement opportunities; tracks and prioritizes projects
to improve coding and documentation outcomes. Develops and implements
action plans to address issues identified through data analysis.
- Provides oversight, guidance,
and training to partner providers and clinicians related to CMS
guidelines and HCC best practices.
- Develops training programs and
tools; performs internal process and policy audits.
- Minimum of 3-5 years in medical
claims coding required
- Experience working with CMS,
health insurers and medical providers strongly desired.
- Experience with the nuances of
diagnosis coding and risk adjustment programs preferred
- Progressively responsible role
with leadership experience and previous experience working in an
educational/training role preferred.
Coding Certification, Certified Professional Coder (CPC), Certified Coding
Specialist – Physician (CCS-P) or Certified Coding Specialist (CCS). Certified
Risk Adjustment Coder (CRC) preferred (required within 6 months of hire)
- Contractors must be a Certified
Coder with a minimum of 2-5 years of HCC coding experience
- Strong computer/technical skills
and strong communication skills
- Must have 2016, 2017, and 2018
ICD-10-CM coding manuals, high-speed and reliable internet, and a Windows
based computer or laptop