Clinical Risk Adjustment Coder
This is NOT a remote position.
Do you like innovation and technology? We do, too. Reveleer is a healthcare software company serving health plans and care management organizations. Our teams are dedicated to disrupting and modernizing healthcare by building powerful technology that provides an amazing user experience, scalability, and automation.
Reveleer is the first of its kind in our space – a self service platform that mines health data using AI, NLP, and advanced analytics. Our Platform enables health plans to focus on the quality of care people receive, leaving the most complex and repetitive tasks for technology to solve. Be part of what Reveleer is building next!
This is a full-time non-exempt position to perform duties for Risk Adjustment Coding and Audit initiatives. As a clinical coder, you will be responsible, but not limited to, coding, confirming and abstracting ICD-10CM diagnosis codes from provider documentation and entering essential information within the Reveleer Platform data entry application.
Essential Duties and Responsibilities
- Reviews medical records to determine if specific disease conditions were correctly reported based on documentation. Reports findings of the data validation review in the data entry feature within the Reveleer Platform.
- Follow the official coding guidelines including AHA Coding Clinic and other similar authoritative resources.
- Ensures project activities are in compliance with applicable coding guidelines, government and federal regulations.
- Regularly and consistently meet quality and productivity standards established by management
- Maintain ongoing communication with management regarding coding workload, turnaround time expectations and deliverables.
- Additional duties as necessary to meet the obligations to our clients.
- Maintains at least 95% accuracy in all coding projects by researching literature and attending professional seminars, workshops and conference as required by AAPC and/or AHIMA to maintain professional certification(s).
- Current Coding Certification (CPC, CPC-P, CPC-H, CPC-I, CRC, CCS, RHIT, RHIA etc.) through AAPC and/or AHIMA
- Minimum of 3 years coding experience with specific knowledge of Medicare and Commercial Risk Adjustment such as Hierarchical Condition category (HCC).
- Additional experience in facility(OPPS/IPPS) coding experience is preferred
- Additional experience in Health Plan Risk Adjustment Data Validation Audit (RADV) experience is preferred
Experience and Skills
- Ability to work independently in a fast-paced remote environment with minimal supervision and guidance
- Ability to interact with management personnel
- Possess strong organizational skills and attention to detail
- Ability to adapt to changing priorities while managing a wide range of projects
- Adaptive and flexible to new ideas and change
- Advanced knowledge of medical terminology, anatomy and pharmacology
- Advanced skills utilizing official coding resources for research and problem solving
- Advanced skills and knowledge of computers, use of required software to perform job functions
- Excellent written and communication skills and the ability to explain complex information
Reveleer is an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, gender identity, sexual orientation, age, marital status, veteran status, disability status or genetic information, in compliance with applicable federal, state and local law.