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Risk Adjustment Medical Coding Specialist Job in Denver, Colorado

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Job Title: Risk Adjustment Medical Coding Specialist

Job Location:Remote
Skills:coding,risk adjustment,ICD-10-HCC(ESRD),Medicare Advantage,medical terminology
Required Certifications:CPC,CRC or CCSP
Required Experience:3 to 4 years
Preferred Experience:5 to 7 years
Location: Denver 80202, CO, US
* Note: This listing is for a remote position
Date Posted:2/10/2020

The Risk Adjustment Medical Coding Specialist is responsible for the timely review of charges submitted by Providers and assigning accurate coding of Services ICD-10 HCC, and when applicable, CPT and HCPCS codes to ensure to ensure proper billing and effective claim submission to the health plan.

This role is REMOTE and will be supporting the Government business side of our Integrated Kidney Care Division.  Responsibilities include the following:

  • Review Provider notes to abstract, assign and enter valid ICD-10/HCC codes into EHR Platform (EPIC)
  • Perform medical chart reviews to identify and correct any missed or erroneous HCC codes according to HCC coding requirements
  • Work with Providers to gain clarification or provide feedback to resolve discrepancies identified during the coding process.
  • Enter charges into the practice management system (MEDfx)
  • File electronic claims within 48-72 hours of entry
  • Other duties as assigned.

What Skills Do you Bring to the Role?

  • 5 years of medical coding experience with a minimum of 2 years as a Risk Adjustment Coder in a health plan
  • Coding Certification required; CPC, CRC or CCSP.
  • Demonstrated proficiency in ICD-10-HCC(ESRD) model of coding guidelines
  • Required knowledge and understanding of Medicare Advantage guidelines
  • Proficient in the areas of Medical Terminology, Anatomy and Physiology, Pharmacology and Electronic Health Record (“EHR”) Systems
  • Proficiency in MS Excel and Word
  • Strong analytical and problem solving skills along  
  • Proven ability to meet deadlines
  • Solid organizational skills and attention to detail
  • Ability to maintain confidentiality of patient information

Ability to work quickly, accurately and independently.



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