Risk Adjustment Coordinator, Hybrid, Palm Beach, Baptist Health Integrated Care, FT, 08A-4:30P

Degrees:

• High School,Cert,GED,Trn,Exper.

Licenses & Certifications:

• AAPC Certified Risk Adjustment Coder.
• AAPC Certified Professional Coder.
• AAPC Certified Professional Medical Auditor.

Additional Qualifications:

• Bachelors of Science degree preferred.
• Certified Professional Coder and/ or Certified Risk Adjustment Coder (CRC).
• CPMA certification must be obtained within 1 year of Hire.
• Required completion of an accredited certified coding specialist program.
• 2+ years of clinic or hospital experience and/ or managed care experience.
• 1+ years of experience in Risk Adjustment and HEDIS/Stars.
• Ability to interpret, analyze and abstract data/documentation.
• Comprehensive Knowledge of ICD-10-CM codes, Category II codes, COA measures, CMS documentation requirements, state and federal regulations including compliance and reimbursement and the impact of diagnosis coding on risk adjustment payment models.
• Ability to identify HCC improvement opportunities and educate clinical providers on proper clinical documentation, compliance, and coding guidelines.
• Intermediate level of proficiency in MS Office – Excel, PowerPoint, and Word.
• Ability to defend coding decisions to both internal and external audits.
• Strong organizational skills in multiple settings, as well as the ability to exercise judgement and initiative.
• Ability to work in a continuously changing environment.

Minimum Required Experience: 5 Years

EOE, including disability/vets