Job details
Job type full-time
Full job description
About the role
The bright health risk adjustment and coding team is an integral component of bright’s success as it defines and ensures outstanding clinical care for our membersAs a coding coordinator you will act as a primary coding contact for compliance oversight with a focus on accuracy and potential coding opportunitiesThe coding coordinator will also be responsible for secondary level quality audits.
Your responsibilities
Participate in risk adjustment coding audits including but not limited to vendor bi-directional chart chases, gap closure, and coding completeness
Play a key role in medical records retrieval; including but not limited to calling provider offices, obtaining medical records from emr systems, and partnering with market nurses for retrieval
Participate in secondary level quality audits of vendor’s work for radv audits and other risk adjustment projects
Responsible for performing code abstraction and/or coding quality audits of medical records to ensure that the icd-10-cm codes are appropriately assigned and supported by clinical documentation
Identifies and tracks areas for documentation improvements and participates in documentation improvement initiatives
Maintain all coding certifications and requirements and keep up to date on knowledge of icd-10 codes, cms documentation requirements, and risk adjustment guidelines
Meet and maintain coding quality and productivity standards
Ensure compliance with all federal rules and regulations
Research and respond to coding questions submitted via the coding inbox
Education, training, and professional experience
Required:
Associate degree or bachelor’s degree required
Three (3) or more years’ experience in medicare advantage and commercial coding and risk adjustment
Current coding certification through aapc or ahima
Extensive knowledge of risk adjustment and icd-10-cm coding guidelines
Extensive knowledge of medicare advantage and commercial hcc models
Proficient in microsoft office products; word, excel, powerpoint
Preferred:
Medical record retrieval experience
Certified risk adjustment coder (crc)
Hhs iva radv experience
Professional competencies
Strong written and verbal communication skills
Strong attention to detail
Vast knowledge of emr systems, medical record review and abstraction
Ability to quickly learn and adapt to meet business needs
Experience working with risk adjustment vendors
Ability to work independently
Ability to build relationships with office staff, physicians, and market team
Licensures and certifications
Current coding certification through aapc or ahima
Certified risk adjustment coder (crc) preferred
About us at bright health, we brought together the brightest minds from the health care industry and consumer technology and together we created bright health: a new, brighter approach to healthcare, built for individualsOur plans are easy to manage, personalized and more affordable, giving people the quality care they deserveThrough our exclusive care partnerships with leading health systems in local communities we are reshaping how people and physicians achieve better health togetherWe’re making healthcare rightTogether.
We've won some fun awards like: great places to work, modern healthcare, forbes, etcBut more than anything, we're a group of people who are really dedicated to our mission in healthcareCome join our growing team! as an equal opportunity employer, we welcome and employ a diverse employee group committed to meeting the needs of bright health, our consumers, and the communities we serveAll qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
