Risk Adjustment Coder Job at Cano Health
Overview:
At Cano Health, our cultural attributes are to be patient centered, service focused, results oriented, trustworthy, transparent, and to continuously improve. Join our collaborative team, dedicated to the pursuit of excellence in health and wellness.
Cano Health offers competitive salaries, medical, dental & vision insurance, employee mental health program, paid time off, paid holidays, 401(k) with employer match, employee stock purchase program, tuition reimbursement and much more.
The Risk Adjustment Coder will identify, collect, assess, monitor and document claims and encounter coding information as it pertains to Clinical Condition Categories. Verify and ensure the accuracy, completeness, specificity, and appropriateness of diagnosis codes based on services rendered. The Risk Adjustment Coder is required to follow procedures and documentation policies regarding claim/encounter information and provide appropriate support to justify their recommendations.
Responsibilities:
Cano Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.
Cano Health fosters a culture driven by providing superior primary care services in the communities we serve, while forming lifelong bonds with our members. Guided by our mission to improve the health, wellness, and quality of life of our patients, Cano Health continues to work towards making a difference in primary healthcare.
At Cano Health, our cultural attributes are to be patient centered, service focused, results oriented, trustworthy, transparent, and to continuously improve. Join our collaborative team, dedicated to the pursuit of excellence in health and wellness.
Cano Health offers competitive salaries, medical, dental & vision insurance, employee mental health program, paid time off, paid holidays, 401(k) with employer match, employee stock purchase program, tuition reimbursement and much more.
The Risk Adjustment Coder will identify, collect, assess, monitor and document claims and encounter coding information as it pertains to Clinical Condition Categories. Verify and ensure the accuracy, completeness, specificity, and appropriateness of diagnosis codes based on services rendered. The Risk Adjustment Coder is required to follow procedures and documentation policies regarding claim/encounter information and provide appropriate support to justify their recommendations.
Responsibilities:
- Review medical record information to identify all appropriate coding based on CMS HCC categories
- Prepare the medical charts and track patient information via Excel spreadsheets.
- Complete appropriate paperwork/documentation/system entry regarding claim/encounter information
- Provide coding support, education and training related to, quality of documentation, level of service and diagnosis coding consistent with established coding guidelines and standards
- Provide real time support and coordination with Primary Care Providers and Care Coordinators for MRA coding, HEDIS and STARS
- Monitor coding changes to ensure that most current information is available
- Work HCC suspect reports
- Accurately code and submit encounters on a timely basis
- Researching and addressing code questions for multiple provider offices as directed
- Update the Director on the status on a weekly basis
- Notifies Patient Experience Manager if annual wellness visits for patients have not been scheduled.
- Travel to offices as necessary to complete on-site chart reviews
- Performs post-audits on assigned offices and notifies office contact when codes are not addressed for provider review.
- Support and participate in process and quality improvement initiatives.
- Assists with billing claims as assigned.
- Two (2) years prior medical coding experience
- Proficient in Microsoft Word and Excel
- Strong organization and process management skills
- Strong collaboration and relationship building skills
- High attention to detail
- Excellent written and verbal communication skills
- Ability to learn new tasks and concepts
- CPC, CPC-A or CCS-P, CRC Coding Certification
Cano Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.
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