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Risk Adjustment Coder Job in Newport Beach, California

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Job Title: Risk Adjustment Coder

Employer:Connected Care Resources, Inc.
Skills:coding,billing,communication,Microsoft Office,analytical
Specialties:Medicare, primary care, chronic
Required Certifications:Certified Risk Adjustment Coder (CRC) certificate from AAPC
Preferred Certifications:EPIC,ICD-9/10 code
Required Experience:1 to 2 years
Preferred Experience:3 to 4 years
Location:4000 MacArthur Blvd Newport Beach 92660, CA, US
Date Posted:6/24/2020

The Company

At Connected Care, our vision is to become the most trusted and innovative healthcare partner. Our mission is to transform healthcare by inspiring excellence, connecting people and empowering one another through compassion. We are a care delivery organization that provides clinical, administrative, and operational services to independent physician practice associations, accountable care organizations, medical groups and health insurance plans including Medicare Advantage health plans.

Job Description and Job Responsibilities

  • The Risk Adjustment Coder ensures coding is accurate and properly supported by clinical documentation within the health record.
  • Follows state and federal regulations as well as internal policies and guidelines while analyzing coding information and medical records.
  • May participate in provider education programs on coding compliance.
  • Decisions are regarding the daily priorities for an administrative work group and/or external vendors including coordinating work activities and monitoring progress towards schedules/goals, and often oversees work of others and/or is the primary administrative owner of a main process, program, product or technology.
  • Maintain compliance with CMS risk adjustment diagnosis coding guidelines.
  • Experience in the preparation or responding to RAD-V audits.
  • Ability to work in a fast-paced production environment while maintaining high quality.
  • Must be able to follow instructions, meet deadlines and work independently.
  • Perform comprehensive 1st pass reviews of medical records and physician assessment forms (HCC coding).
  • Assist with the intake and quality assurance of medical records as necessary.
  • Perform or participate in special projects as directed by management.

Job Qualifications/Education

  • Associates degree or equivalent work experience required. Equivalent experience is defined as 2 years of professional work experience.
  • 1 year - Progressive medical coding and health care experience required.

Skills Certifications

  • 1-5-year(s) experience in professional coding certification from AHIMA or AAPC (CPC, CCS, RHIT, RHIA) + Strong knowledge of ICD-9/10 code.
  • Must have the Certified Risk Adjustment Coder (CRC) certificate from AAPC.
  • Must have proficiency in an EHR. **EPIC preferred
  • Ability to work independently with minimal supervision or function in a team environment sharing responsibility, roles and accountability.
  • Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint)
  • Proven analytical and problem-solving skills and ability to perform non-routine analytical tasks.
  • Must be a team player, be organized and have the ability to handle multiple projects.
  • Excellent oral and written communication skills.
  • Strong interpersonal and organizational skills.
  • Understanding of ICD-10 coding standards required.


Working Conditions and Additional Requirements

  • Fast paced office and healthcare environment handling multiple demands
  • Professional business environment within the CCRI offices
  • Blend of internal and external (community, provider, regulatory) activity
  • While performing the duties of this job, the employee is regularly required to sit, walk, and stand. The employee will be required to talk or hear on the phone and utilize a computer


Confidential Data

All information (written, verbal, electronic, etc.) that an employee encounters while working at CCRI is considered confidential. Exposed to and required to deal with highly confidential and sensitive material and must adhere to corporate compliance policy, department guidelines/policies and all applicable laws and regulations at all times.

Equal Opportunity Employee

CCRI is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.


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